Publications (10)26.33 Total impact
-
Article: Preventing HIV by providing support for orphan girls to stay in school: does religion matter?
[show abstract] [hide abstract]
ABSTRACT: Objective The paper examines the influence of religion on attitudes, behaviors, and HIV infection among rural adolescent women in Zimbabwe. Design We analyzed data from a 2007 to 2010 randomized controlled trial in rural eastern Zimbabwe testing whether school support can prevent HIV risk behaviors and related attitudes among rural adolescent orphan girls; supplementary data from the 2006 Zimbabwe Demographic and Health Survey (ZDHS) were also analyzed. The present study design is largely cross-sectional, using the most recent available survey data from the clinical trial to examine the association between religious affiliation and religiosity on school dropout, marriage, and related attitudes, controlling for intervention condition, age and orphan type. The ZDHS data examined the effect of religious denomination on marriage and HIV status among young rural women, controlling for age. Results Apostolic Church affiliation greatly increased the likelihood of early marriage compared to reference Methodist Church affiliation (odds ratio = 4.5). Greater religiosity independently reduced the likelihood of school dropout, increased gender equity attitudes and disagreement with early sex, and marginally reduced early marriage. Young rural Apostolic women in the ZDHS were nearly four times as likely to marry as teenagers compared to Protestants, and marriage doubled the likelihood of HIV infection. Conclusions Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV infection for young married women and their infants in high prevalence areas, further study is urgently needed to confirm this emerging public health problem, particularly among orphan girls. Although empirical evidence suggests that keeping orphan girls in school can reduce HIV risk factors, further study of the religious context and the implications for prevention are needed.Ethnicity and Health 06/2012; · 1.64 Impact Factor -
Article: Process and outcome evaluation of a community intervention for orphan adolescents in Western kenya.
[show abstract] [hide abstract]
ABSTRACT: We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed null effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems.Journal of Community Health 02/2012; 37(5):1101-9. · 1.28 Impact Factor -
Article: Keeping adolescent orphans in school to prevent human immunodeficiency virus infection: evidence from a randomized controlled trial in Kenya.
[show abstract] [hide abstract]
ABSTRACT: We report the findings from a pilot study in western Kenya, using an experimental design to test whether comprehensive support used to keep adolescent orphans in school can reduce risk factors associated with infection with human immunodeficiency virus. Adolescent orphans aged 12-14 years (N = 105) in Nyanza Province were randomized to condition, after stratifying by household, gender, and baseline survey report of sexual behavior. The intervention comprised school fees, uniforms, and a "community visitor" who monitored school attendance and helped to resolve problems that would lead to absence or dropout. Data were analyzed using generalized estimating equations over two time points, controlling for gender and age. Compared with the control group, intervention students were less likely to drop out of school, commence sexual intercourse, or report attitudes supporting early sex. School support also increased prosocial bonding and gender equity attitudes. After 1 year of exposure to the intervention, we found evidence suggesting that comprehensive school support can prevent school dropout, delay sexual debut, and reduce risk factors associated with infection with human immunodeficiency virus. Further research, with much larger samples, is needed to better understand factors that mediate the association between educational support and delayed sexual debut, and how gender might moderate these relationships.Journal of Adolescent Health 05/2011; 48(5):523-6. · 3.33 Impact Factor -
Article: Gene-environment contributions to young adult sexual partnering.
[show abstract] [hide abstract]
ABSTRACT: To date, there has been relatively little work on gene-environment contributions to human sexuality, especially molecular analyses examining the potential contributions of specific polymorphisms in conjunction with life experiences. Using Wave III data from 717 heterozygous young adult sibling pairs included in the National Longitudinal Study of Adolescent Health, this article examined the combined contributions of attendance at religious services and three genetic polymorphisms (in the dopamine D4 receptor [DRD4]), dopamine D2 receptor [DRD2]), and the serotonin transporter promoter [5HTT]) to sensation seeking, a personality construct related to sexual behavior, and the number of vaginal sex partners participants had in the year before interview. Data analyses used an Allison mixed model approach to account for population stratification and correlated observations. DRD4 was unrelated to sensation seeking and to the number of sex partners in tests of both main effects and in interaction with religious attendance. Contrary to hypothesis, presence of the A1 DRD2 allele was associated with having had fewer sex partners in the past year. Associations between the 5HTT allele and sex partners varied by religious attendance, but again the patterns of associations were contrary to hypothesized relationships and were small in magnitude. These findings underscore the necessity of using more comprehensive multiple gene-multiple life experience approaches to investigations of complex behaviors such as sexual patterns.Archives of Sexual Behavior 09/2007; 36(4):543-54. · 3.53 Impact Factor -
Article: Racial and gender differences in adolescent sexual attitudes and longitudinal associations with coital debut.
[show abstract] [hide abstract]
ABSTRACT: Delay of sexual debut is an important strategy in reducing the risk of negative adolescent health outcomes. Race and gender are known to be related to sexual behavior and outcomes, but little is known about how these characteristics affect sexual attitudes. This article examines differences in coital and pregnancy attitudes by gender and race, the influence of attitudes on transition to first coitus for each subgroup, and implications for prevention. Data are from Waves I and II of the National Longitudinal Study of Adolescent Health, limited to Non-Hispanic White and African American adolescents (n = 6652). We factor analyzed attitude items, and examined effects of race, gender, and their interaction, controlling for sexual debut at Wave I. We regressed sexual debut longitudinally by attitudes for virgins (n = 3281) separately for each subgroup, controlling for covariates. Compared with boys, girls perceived less positive benefits from sex and more shame and guilt with sex, but had fewer negative perceptions about pregnancy. Compared with White boys, African American boys perceived less shame and guilt about sex; girls did not differ by race. Higher perceived benefits of sex increased the likelihood of sexual debut among African American girls. Perceived shame and guilt lowered the likelihood for White boys and girls. Reinforcing protective attitudes through gender and race-specific programs may delay sexual intercourse, but more research is needed. More research is also needed to determine whether there is an optimal coital age after which negative health outcomes are attenuated, and whether this differs by gender and race.Journal of Adolescent Health 08/2007; 41(1):19-26. · 3.33 Impact Factor -
Article: Sexual behavior and drug use among Asian and Latino adolescents: association with immigrant status.
[show abstract] [hide abstract]
ABSTRACT: This paper contributes new evidence on the association between immigrant status and health by describing and attempting to explain patterns of co-occurring sex and drug use behaviors among Asian and Latino adolescents in the United States. Nine patterns of sex and drug use behaviors were identified from a cluster analysis of data from 3,924 Asian and Latino youth (grades 7-12) who participated in the National Longitudinal Study of Adolescent Health (Add Health). The relationship between immigrant status and risk cluster membership was evaluated with multinomial logistic regression. Compared to foreign-born youth, U.S. born Asian and Latino adolescents were more likely to engage in sex and drug risk behaviors. Family and residential characteristics associated with immigrant status partly accounted for this finding. The results indicate that among Asian and Latino adolescents, assimilation to U.S. risk behavior norms occurs rapidly and is evident by the second generation.Journal of Immigrant and Minority Health 05/2007; 9(2):85-94. · 1.16 Impact Factor -
Article: Does federal policy support the use of scientific evidence in school-based prevention programs?
[show abstract] [hide abstract]
ABSTRACT: Since 1998, federal policy has explicitly required the use of "evidence-based" prevention programs in schools. We review how this policy has been implemented through state recipients of the Safe and Drug Free Schools (SDFS) Program, and how other federal and private agencies have supported the policy by providing guidance about the scientific evidence for specific programs' effectiveness. We report data from a survey of SDFS state office directors, and we compare and contrast the most popular lists of effective programs. State offices supply the infrastructure for administering the SDFS Program, providing technical assistance to local school districts, monitoring the implementation of federal policy at the local level, and determining funding eligibility based on compliance. We found that states rely heavily on federal lists to determine whether school districts are meeting federal policy requirements, particularly the National Registry of Effective Programs and Practices (NREPP). Both SDFS and NREPP are changing, however, and the changes do not bode well for the transfer of prevention science to schools. Conclusions and recommendations are presented.Prevention Science 04/2007; 8(1):75-81. · 2.63 Impact Factor -
Article: Which comes first in adolescence--sex and drugs or depression?
[show abstract] [hide abstract]
ABSTRACT: The notion that adolescents "self-medicate" depression with substance use and sexual behaviors is widespread, but the temporal ordering of depression and these risk behaviors is not clear. This study tests whether gender-specific patterns of substance use and sexual behavior precede and predict depression or vice versa. Data are from the National Longitudinal Study of Adolescent Health, weighted to produce population estimates. The sample includes 13,491 youth, grades 7 to 11, interviewed in 1995 and again 1 year later. Multivariate logistic regression analyses, conducted in 2004, tested temporal ordering, controlling for covariates. The main outcome measures were depression, as measured by a modified Center for Epidemiological Studies-Depression Scale (CES-D), and three behavior patterns: (1) abstaining from sexual intercourse and drug use, (2) experimental behavior patterns, and (3) high-risk behavior patterns. Overall, sex and drug behavior predicted an increased likelihood of depression, but depression did not predict behavior. Among girls, both experimental and high-risk behavior patterns predicted depression. Among boys, only high-risk behavior patterns increased the odds of later depression. Depression did not predict behavior in boys, or experimental behavior in girls; but it decreased the odds of high-risk behavior among abstaining girls (RRR = 0.14) and increased the odds of high-risk behavior (RRR = 2.68) among girls already experimenting with substance use. Engaging in sex and drug behaviors places adolescents, and especially girls, at risk for future depression. Future research is needed to better understand the mechanisms of the relationship between adolescent behavior and depression, and to determine whether interventions to prevent or stop risky behaviors will also reduce the risk of later depression.American Journal of Preventive Medicine 11/2005; 29(3):163-70. · 4.04 Impact Factor -
Article: Implementing evidence-based substance use prevention curricula in North Carolina public school districts.
[show abstract] [hide abstract]
ABSTRACT: The Safe and Drug-Free Schools and Communities Act (SDFSCA) provides funding for prevention education to nearly every school district in the nation. Recent federal policy requires SDFSCA recipients to implement evidence-based prevention programs. This paper reports the extent to which North Carolina public school districts implement evidence-based substance use prevention curricula. Results showed that while the majority of school districts use evidence-based prevention curricula, they are rarely the most commonly used curricula. Evidence-based curricula are much more likely to be used at the middle school level than at the elementary or high school levels. Urbanicity, coordinator time, and coordinator experience correlated with extensive use of evidence-based curricula in the bivariate analysis, but only time spent on prevention by the Safe and Drug-Free Schools (SDFS) coordinator significantly predicted extensive use in the multivariate analysis. Increasing district SDFSCA coordinator time is a necessary step for diffusing evidence-based curricula.Journal of School Health 12/2004; 74(9):353-8. · 1.34 Impact Factor -
Article: Adolescent depression and suicide risk: association with sex and drug behavior.
[show abstract] [hide abstract]
ABSTRACT: Depression is common among adolescents, and suicide is the third leading cause of death among 15- to 19-year-olds. Although both health problems have been associated with drug use and early sexual intercourse, the relationship has not been systematically studied in a nationally representative sample. Sixteen patterns of combined sex and drug use behaviors were obtained using cluster analysis of responses to Wave I of the National Longitudinal Study of Adolescent Health conducted from September 1994 through December 1995. Bivariate and multivariate analyses tested correlations between behavior patterns and current depression, serious suicidal ideation, and previous suicide attempt, controlling for gender, race/ethnicity, Hispanic ethnicity, family structure, and parent education. Compared to youth who abstain from risk behaviors, involvement in any drinking, smoking, and/or sexual activity was associated with significantly increased odds of depression, suicidal ideation, and suicide attempts. Odds ratios were highest among youth who engaged in illegal drug use. There were few differences between boys and girls who abstain from sex and drug behaviors. Girls were less likely than boys to engage in high-risk behaviors, but those who did tended to be more vulnerable to depression, suicidal ideation, and suicide attempt. Teens engaging in risk behaviors are at increased odds for depression, suicidal ideation, and suicide attempts. Although causal direction has not been established, involvement in any sex or drug use is cause for concern, and should be a clinical indication for mental health screening for girls; both boys and girls should be screened if engaging in any marijuana or illegal drug use.American Journal of Preventive Medicine 11/2004; 27(3):224-31. · 4.04 Impact Factor
Top co-authors
Top Journals
Institutions
-
2004–2012
-
Pacific Institute for Research and Evaluation
Calverton, MD, USA
-
-
2004–2007
-
University of North Carolina at Chapel Hill
- Carolina Population Center
Chapel Hill, NC, USA
-
