Amanda E Tanner

University of North Carolina at Greensboro, Greensboro, North Carolina, United States

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Publications (24)38.66 Total impact

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    ABSTRACT: This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined.
    Social science & medicine (1982). 07/2014; 118C:52-60.
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    ABSTRACT: In time, microbicides may provide women with dual prevention against pregnancy and STDs. Although several microbicide dimensions have been evaluated, little is known about women's preferences for contraceptive microbicides and correlates of these preferences. Acceptability of a hypothetical contraceptive microbicide cream or jelly was examined among a -clinic-based sample of 266 women in Indianapolis from 2004 (when participants were aged 14-22) to 2008. Group conjoint analyses and individual conjoint analyses were used to compare preferences with respect to four microbicide -dimensions: contraceptive ability, efficacy in relation to condoms, timing of use and texture. Pearson's product moment correlations were used to examine the relationship between preferences for a contraceptive microbicide and selected characteristics of the women. Overall, the top-rated microbicide dimensions were efficacy in relation to that of condoms and contraceptive ability (importance scores, 40.0 and 35.4 out of 100.0, respectively). When all dimension levels were compared, contraceptive ability was the most strongly preferred (part-worth utility score, 8.9), and lower efficacy than that of -condoms was the least strongly preferred (-11.9). Preference for contraceptive microbicides was positively -associated with current contraceptive use, sexual agency, partner communication, commitment to avoiding pregnancy and -perceived partner agreement about avoiding pregnancy (coefficients, 0.07-0.18). It was negatively associated with current or past nonuse of contraceptives, seeking pregnancy and perceived partner agreement about seeking -pregnancy (-0.08 to -0.14). Microbicides with dual prevention properties may be attractive to young women. Microbicide development and subsequent clinical trials should incorporate contraceptive microbicides.
    Perspectives on Sexual and Reproductive Health 12/2013; · 1.41 Impact Factor
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    ABSTRACT: Early linkage to care and engagement in care are critical for initiation of medical interventions. However, over 50 % of newly diagnosed persons do not receive HIV-related care within 6 months of diagnosis. We evaluated a linkage to care and engagement in care initiative for HIV-positive adolescents in 15 U.S.-based clinics. Structural and client-level factors (e.g. demographic and behavioral characteristics, clinic staff and location) were evaluated as predictors of successful linkage and engagement. Within 32 months, 1,172/1,679 (69.8 %) of adolescents were linked to care of which 1,043/1,172 (89 %) were engaged in care. Only 62.1 % (1,043/1,679) of adolescents were linked and engaged in care. Linkage to care failure was attributed to adolescent, provider, and clinic-specific factors. Many adolescents provided incomplete data during the linkage process or failed to attend appointments, both associated with failure to linkage to care. Additional improvements in HIV care will require creative approaches to coordinated data sharing, as well as continued outreach services to support newly diagnosed adolescents.
    AIDS and Behavior 10/2013; · 3.49 Impact Factor
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    ABSTRACT: Linkage and engagement in care are critical corollaries to the health of HIV-infected adolescents. The adolescent HIV epidemic and adolescents' unique barriers to care necessitates innovation in the provision of care, including the consideration of the clinical experience. Little research has addressed how "youth friendly" clinics may influence care retention for HIV-infected youth. We conducted 124 interviews with providers, outreach workers, and case managers, at 15 Adolescent Medicine Trials Network clinics. Photographs of each clinic documented the characteristics of the physical space. Constant comparison and content and visual narrative methods were utilized for data analysis. Three elements of youth friendliness were identified for clinics serving HIV-infected youth, including: (1) role of target population (e.g., pediatric, adolescent, HIV); (2) clinics' physical environment; and (3) clinics' social environment. Working to create 'youth friendly' clinics through changes in physical (e.g., space, entertainment, and educational materials) and social (e.g., staff training related to development, gender, sexual orientation) environments may help reduce HIV-infected adolescents' unique barriers to care engagement. The integration of clinic design and staff training within the organization of a clinical program is helpful in meeting the specialized needs of HIV-infected youth.
    AIDS Care 06/2013; · 1.60 Impact Factor
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    ABSTRACT: Linkage to care is a critical corollary to expanded HIV testing, but many adolescents are not successfully linked to care, in part due to fragmented care systems. Through a collaboration of the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and the Adolescent Trials Network (ATN), a linkage to care outreach worker was provided to ATN clinics. Factors related to linkage were explored to better understand how to improve retention rates and health outcomes for HIV-positive adolescents. We conducted 124 interviews with staff at 15 Adolescent Trials Network clinics to better understand linkage to care processes, barriers, and facilitators. Content analysis was conducted focusing on structural barriers to care and potential solutions, specifically at the macro-, meso-, and micro-levels. Macro-level barriers included navigating health insurance policies, transportation to appointments, and ease of collecting and sharing client-level contact information between testing agencies, local health departments and clinics; meso-level barriers included lack of youth friendliness within clinic space and staff, and duplication of linkage services; micro-level barriers included adolescents' readiness for care and adolescent developmental capacity. Staff initiated solutions included providing transportation for appointments and funding clinic visits and tests with a range of grants and clinic funds while waiting for insurance approval. However, such solutions were often ad hoc and partial, using micro-level solutions to address macro-level barriers. Comprehensive initiatives to improve linkage to care are needed to address barriers to HIV-care for adolescents, whose unique developmental needs make accessing care particularly challenging. Matching the level of structural solution to the level of structural barriers (i.e., macro-level with macro-level), such as creating policy to address needed youth healthcare entitlements versus covering uninsured patients with clinic funds is imperative to achieving the goal of increasing linkage to care rates for newly diagnosed adolescents.
    AIDS Care 06/2013; · 1.60 Impact Factor
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    ABSTRACT: Due to high cervical cancer rates and limited research on human papillomavirus (HPV) vaccine acceptability in India, the research team examined parental attitudes toward HPV vaccines. Thirty-six interviews with parents were conducted to assess sexually transmitted infection (STI)-related knowledge and HPV-specific vaccine awareness and acceptability. Despite limited knowledge, parents had positive views toward HPV vaccines. Common barriers included concerns about side effects, vaccine cost, and missing work to receive the vaccine. Parents were strongly influenced by health care providers' recommendations. Our findings suggest that addressing parental concerns, health worker training and polices, and efforts to minimize cost will be central to successful HPV vaccine implementation.
    Health Care For Women International 01/2013; · 0.63 Impact Factor
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    ABSTRACT: The fragmentation of HIV-related diagnostic and treatment services, especially for youth, is a significant barrier for transitioning to care. The study identified key elements that affected care linkage efforts. We conducted 64 interviews across 15 clinical sites. The constant comparative method was used. Primary linkage to care processes are illustrated through three geographically diverse case studies. Factors included: inter-agency relationships, data sharing protocols, and service duplication concerns. Program improvement strategies were discussed. A strong, citywide network is helpful in coordinating care linkage services. These partnerships will be critical in effectively realizing the goals of the National HIV/AIDS.
    Journal of HIV/AIDS & Social Services 01/2013; 12(3-4).
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    ABSTRACT: This study examined young women's actual timing of use of a microbicide surrogate gel (vaginal moisturiser (VM)) compared with assigned timing conditions. Participants used a VM with coitus during 4-week cycles over a 3-year period in random timing sequences: 1h before coitus, 10 min before coitus and 10 min after coitus. Daily diaries collected information related to coital behaviours, VM use and timing, and participants' and partners' VM assessments. Descriptive and mixed-effects model analyses were conducted. At least three VM timing conditions were completed by 109 women aged 18-22 years old. Of 17?772 diary days collected, coitus was reported on 2128 (1252 with VM use; 59%). Median times between VM application and coitus were: 60 min before coitus (mean=68.2; s.d.=76.9) for the 1-h pre-coital group, 13.5 min before coitus (mean=44.9; s.d.=117.1) for the 10-min pre-coital group and 5 min before coitus (mean=24.5; s.d.=205.1) for the 10-min post-coital group. Women reported that the VM was very easy to use (68%), it was somewhat messy (61%), they were very wet during sex (81%), sex was very good (80%) and their partners liked using the VM (38%). Overall, the VM was rated positively. There was substantial deviation in application time across timing conditions, with significantly greater variability in the post-coital group. These findings contribute to understanding of how VMs are accepted and used, with implications for HIV prevention with microbicides requiring specific application timing.
    Sexual Health 09/2012; 9(4):299-303. · 1.65 Impact Factor
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    ABSTRACT: Although underutilized, the vaginal contraceptive ring has several advantages over other contraceptive methods that could benefit adolescents. We examined factors that may influence willingness to try the vaginal ring including: sexual and contraceptive history, genital comfort, and vaginal ring characteristics. Cross sectional Midwestern adolescent health clinics Adolescent women (N = 200; 14-18 years; 89% African-American) INTERVENTIONS/MAIN OUTCOME MEASURES: All participants received education about the vaginal ring and viewed pictures demonstrating insertion; they then completed a visual/audio computer-assisted self interview. The primary outcome variable, willingness to try the vaginal ring, was a single Likert-scale item. Over half the participants reported knowledge of the vaginal ring with healthcare providers identified as the most important source of contraceptive information. Comfort with one's genitals, insertion and removal, using alternative methods of insertion, and knowing positive method characteristics were significantly associated with willingness to try the vaginal ring. A decreased willingness to try the vaginal ring was related to concerns of the ring getting lost inside or falling out of the vagina. Willingness to try the ring was associated with positive feelings about genitals (e.g., comfort with appearance, hygiene, function). Thus, to increase willingness to try the vaginal ring among adolescents, providers should make it common practice to discuss basic female reproductive anatomy, raise awareness about female genital health and address concerns about their genitals. Providers can offer alternative insertion techniques (e.g., gloves) to make use more accessible. These strategies may increase vaginal ring use among adolescents.
    Journal of pediatric and adolescent gynecology 03/2011; 24(4):204-10. · 0.90 Impact Factor
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    ABSTRACT: First coitus is considered a major transitional event imbued with cultural relevance. Research has focused on classifying women as virgins, with primary interest in pregnancy and sexually transmitted infection prevention and less on sexuality. This study prospectively explored young women's sexual interest and love at first and subsequent coitus. Daily diary data were collected during a longitudinal study of young women's sexual health (N = 387; 14-17 years at enrollment). Variables of interest included sexual interest, love, and contraceptive and disease prevention behaviors. Analysis of variance and multinomial logistic regression were utilized. For first coital events, love and sexual interest were reported about "half of the day," with sexual interest significantly higher on the day of first coitus. Condom use was nine times more likely than no method at first compared to later coital events. For subsequent coitus, feeling of being in love was significantly higher compared to first coitus, with average sexual interest and love significantly higher with use of no contraceptive method over condoms. Condoms were associated with higher feelings of being in love, but lower sexual interest compared to hormonal contraception. The results indicated that sexual interest and love are independent components of coital behavior. Yet the results also suggest that young women's first coitus does not fully capture the expected significance of "losing one's virginity." Thus, at first coitus, women can actively engage in protective behaviors and focus on pleasure.
    Journal of Adolescent Health 07/2010; 47(1):20-5. · 2.97 Impact Factor
  • Journal of Pediatric and Adolescent Gynecology. 04/2010; 23(2):e63–e64.
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Sexually transmitted diseases 02/2010; 37(2):129-30. · 2.58 Impact Factor
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    Janice McCabe, Amanda E. Tanner, Julia R. Heiman
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    ABSTRACT: This study uses cognitive interviewing to examine individuals’ interpretations of sexuality-related questions and meanings of sex and sexuality. The sample includes 20 adults (12 women and 8 men) who were randomly selected university staff in the Midwestern United States. Using a sexual script and symbolic interactionist framework, we identify two themes in individuals’ understandings of sex and sexuality: (1) people’s talk about sexuality at the cultural level typically corresponds to traditional gender arrangements and stereotypes; however, personal experiences elicit more contradictions and (2) our relatively small sample revealed a wide range of understandings of sex and sexuality, including how gender expectations influenced their meanings. Implications for theoretical work on gender and sexuality as well as future empirical studies are discussed. KeywordsGender-Sexuality-Methodology-Cognitive interviewing-Sexual scripts
    Sex Roles 01/2010; 62(3):252-263. · 1.47 Impact Factor
  • Journal of Adolescent Health - J ADOLESCENT HEALTH. 01/2010; 46(2).
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    Jenny A Higgins, Amanda E Tanner, Erick Janssen
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    ABSTRACT: Few studies have examined arousal loss associated with safer-sex practices or the perceived risk of unintended pregnancy, let alone its associations with sexual risk practices. An Internet survey conducted in 2004-2006 among 2,399 men and 3,210 women asked respondents about arousal loss related to the use of condoms or other safer-sex products and perceived unintended pregnancy risk. Regression analyses gauged associations between arousal profiles, unprotected sex in the last year and lifetime experience of unintended pregnancy. Many respondents reported arousal loss related to the use of safer-sex products (34%) or the risk of unintended pregnancy (46%). Participants who strongly agreed that use of safer-sex products can lessen their arousal were significantly more likely to have had unprotected sex in the last year than were those who strongly disagreed (odds ratios, 1.8 for men and 3.7 for women); those who strongly disagreed that pregnancy risk can lessen their arousal were significantly more likely to have been involved in an unintended pregnancy than were those who strongly agreed (2.0 for men and 1.4 for women). Arousal loss related to safer-sex practices was more strongly associated with unprotected sex among women than among men, whereas arousal loss related to pregnancy risk was more strongly associated with unintended pregnancy among men than among women. Some men and women are turned off by safer-sex practices or by pregnancy risk. Given arousal profiles' potential contributions to unintended pregnancies and STD transmission, they should be integrated into sexual health behavioral models, research and programming.
    Perspectives on Sexual and Reproductive Health 10/2009; 41(3):150-7. · 1.41 Impact Factor
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    ABSTRACT: Adolescents are an important target for microbicide research, as they are disproportionately affected by sexually transmitted infections and currently are underrepresented in the microbicide research literature. Furthermore, adolescents are psychosocially and biologically different from adults, and findings from adult research cannot be assumed to apply universally to adolescents. Adolescents, to date have rarely been included in clinical trials and acceptability research for microbicides, in part because their participation requires attention to unique developmental issues, including parental consent and confidentiality. Despite these challenges, adolescents should be included in microbicide clinical research. If adolescents are ultimately expected to use microbicides, it is essential that we understand the developmental, contextual, and relationship variables that may influence use and acceptability. Accordingly, the goal of this paper was to examine the issues affecting the inclusion of adolescents in microbicide clinical research as well as review the existing adolescent-specific microbicide research, which highlights the various factors that may influence use and acceptability. It is hoped that this review can provide guidance for future work with this important, specialized population.
    Journal of pediatric and adolescent gynecology 08/2009; 22(5):285-91. · 0.90 Impact Factor
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    ABSTRACT: Currently in clinical trials, vaginal microbicides are proposed as a female-initiated method of sexually transmitted infection prevention. Much of microbicide acceptability research has been conducted outside of the United States and frequently without consideration of the social interaction between sex partners, ignoring the complex gender and power structures often inherent in young women's (heterosexual) relationships. Accordingly, the purpose of this study was to build on existing microbicide research by exploring the role of male partners and relationship characteristics on young women's use of a microbicide surrogate, an inert vaginal moisturizer (VM), in a large city in the United States. Individual semi-structured interviews were conducted with 40 young women (18-23 years old; 85% African American; 47.5% mothers) following use of the VM during coital events for a 4 week period. Overall, the results indicated that relationship dynamics and perceptions of male partners influenced VM evaluation. These two factors suggest that relationship context will need to be considered in the promotion of vaginal microbicides. The findings offer insights into how future acceptability and use of microbicides will be influenced by gendered power dynamics. The results also underscore the importance of incorporating men into microbicide promotion efforts while encouraging a dialogue that focuses attention on power inequities that can exist in heterosexual relationships. Detailed understanding of these issues is essential for successful microbicide acceptability, social marketing, education, and use.
    Archives of Sexual Behavior 03/2009; 39(3):735-47. · 3.53 Impact Factor
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    ABSTRACT: Currently in clinical trials, microbicides have historically been promoted as a woman-controlled (although more recently woman initiated) method of sexually transmitted infection (STI) prevention. The contradicition that exists in this rationale is that women's bodies, specifically the genitals, have been constructed as a negotiated space within sexual interactions. This study qualitatively explored the factors influencing 40 young women's use of a vaginal moisturizer (VM), utilized as a microbicide surrogate. The results indicated that use of the VM was dependent upon product characteristics (i.e., the lubricating qualities affect on sexual pleasure, timing of insertion), individual factors (i.e., reproductive health goals, experiences with side effects of existing contraceptive methods), and contextual factors (i.e., social norms). An understanding of these bodily and social issues may be beneficial in designing targeted educational campaigns and effective instructional materials as well as in facilitating positive dialogue around women's bodies and their sexuality.
    The Journal of Sex Research 12/2008; 46(1):15-23. · 2.53 Impact Factor
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    ABSTRACT: The purpose of this study was to assess adolescent women's preferences for specific microbicide characteristics including pregnancy prevention, timing of application, potential for side effects, and whether it targeted human immunodeficiency virus (HIV) or other sexually transmitted infections (STI). Potential differences in microbicide preferences by adolescent age group and behavioral patterns including engaging in sexual intercourse and use of hormonal contraception were examined, as it was hypothesized that as adolescents progress into adulthood and gain sexual experience their preferences in microbicide characteristics may shift. Adolescent and young women (N = 405, 56.0% African American; 24.0% Euro-American) between the ages of 14 and 20 (mean = 17.0, SD = 1.8) were recruited from urban community-based clinics. Video-Audio Computer-Assisted Self-Interviews were conducted with the young women, during which they were asked about their preferences regarding the characteristics of hypothetical vaginal microbicides. Conjoint analysis was utilized to determine adolescent women's relative preferences for each microbicide characteristic and intent-to-purchase microbicides based upon a combination of the selected properties. Overall, the results suggest adolescent and young women had an ordered preference for a microbicide with (1) no side effects, (2) pregnancy prevention, (3) postcoital application, and (4) protection against HIV. Age and behavioral group conjoint analyses resulted in the same pattern of preferences as those reported for the entire group. However, women having sex and not using hormonal contraception had a stronger preference for postcoital application. The findings suggest that young women's ratings of microbicides were sensitive to characteristics such as side effects, pregnancy prevention, and timing of application and should be considered in microbicide development. The conjoint analysis approach is useful in understanding microbicide preferences, and should be utilized with other populations to assess preferences for specific microbicide characteristics.
    Journal of Adolescent Health 11/2008; 43(4):349-56. · 2.97 Impact Factor
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    Amanda E Tanner
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    ABSTRACT: Vaginal microbicides, substances that may substantially decrease transmission of sexually transmitted infections (STI) including human immunodeficiency virus (HIV), are currently in clinical trials. They are being presented as woman-initiated prevention methods that have the potential to be used without partners' knowledge. However, it is recognised that covert use may be challenging, due to the accompanying increase in vaginal lubrication. This study explored factors that may influence acceptability and utilisation of vaginal microbicides in Ghana, a sub-Saharan West African country with relatively low rates of HIV. Qualitative research methods were employed in Accra, Ghana in 2005. Individual interviews were conducted with 10 staff working in reproductive health settings, and two focus groups were conducted with young women aged 24-28. Three main topics emerged during the interviews and focus groups, including issues related to available contraceptive and prevention methods, perceptions of microbicide interest and acceptability, and cultural influences on microbicide acceptability and use. Participants discussed issues associated with available contraceptive options that may influence microbicide uptake. All respondents suggested that Ghanaian women would have a high level of interest in microbicides, with varying interest in formulas with different contraceptive and disease prevention properties. Cultural factors that may impact on microbicide use, often related to gender and power issues, were also discussed. Thus, as microbicides are being developed, cultural issues and behavioral correlates will need to be assessed to help ensure acceptability and use. In addition, gendered negotiation power and the implications of covert use need to be addressed in microbicide education and social marketing.
    SAHARA J: journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council 05/2008; 5(1):11-8. · 0.81 Impact Factor

Publication Stats

150 Citations
38.66 Total Impact Points

Institutions

  • 2012–2014
    • University of North Carolina at Greensboro
      • Department of Public Health Education
      Greensboro, North Carolina, United States
  • 2013
    • Georgia Regents University
      • Department of Psychology
      Augusta, Georgia, United States
  • 2009–2013
    • Johns Hopkins Bloomberg School of Public Health
      • Department of Health, Behavior and Society
      Baltimore, MD, United States
    • Johns Hopkins University
      • Department of Health, Behavior and Society
      Baltimore, MD, United States
  • 2008–2011
    • Indiana University-Purdue University Indianapolis
      • Section of Adolescent Medicine
      Indianapolis, IN, United States
  • 2010
    • University of North Carolina at Charlotte
      • Department of Public Health Sciences
      Charlotte, NC, United States
  • 2007
    • Indiana University Bloomington
      • Department of Applied Health Science
      Bloomington, Indiana, United States