Publications (21)64.88 Total impact
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Article: Who gives and who gets: why, when, and with whom young people engage in oral sex.
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ABSTRACT: Surprisingly little is known about oral sex experiences among emerging adults, including the motives behind their participation in this sexual activity. The current study examined the characteristics of emerging adults' most recent oral sex experience. A total of 431 young people (M age = 21.7 years; 71.7% female) completed an on-line survey assessing their sexual history, context (partner type, co-occurring sexual behaviors), and motives (physical, emotional, goal attainment, and insecurity) for engaging in their most recent heterosexual oral sex interaction. The majority of oral sex encounters occurred within the context of a committed relationship and during an interaction that also included intercourse. Cunnilingus was rare unless reciprocated with fellatio. Overall, both males' and females' reports indicate that they were motivated to engage in oral sex by sexual desire and attraction to their partner, or to enhance an emotional connection with their partner. Insecurity and goal attainment motives were uncommon. Males reported more physical motives than did females, and females reported more emotional and insecurity motives than did males. The findings provide insights into youths' oral sex experiences, and make clear how essential it is to understand the broader sexual and partnership context in which a given sexual activity occurs. These findings have implications for policies aimed at the development of effective sexual health education programs.Journal of Youth and Adolescence 02/2012; 41(5):572-82. · 2.72 Impact Factor -
Article: Communicating interest in sex: verbal and nonverbal initiation of sexual activity in young adults' romantic dating relationships.
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ABSTRACT: Relatively little is known about the day-to-day initiation of sexual activity between young adults in committed relationships, notably the ways in which young people communicate interest in sexual activity. Sexual script theory (Simon and Gagnon, Society 22:53-60, 1984) posits that men are traditionally the initiators and women the restrictors of sexual activity early in relationships. However, research suggests that these patterns may be different for individuals in committed relationships. The current study used a diary method to examine verbal/nonverbal and indirect/direct initiation strategies, responses to initiations, and patterns between initiations and responses. Participants included 31 men and 32 women between the ages of 18 and 24 years who were involved in committed heterosexual relationships. Men initiated more frequently than did women and most initiations were nonverbal initiation (91%) rather than verbal (65%). Responses to initiations tended to match the initiators' choice of strategies, suggesting that synchrony plays an important role in initiation patterns. The findings have implications for understanding sexual communication as well as relationship and sexual satisfaction among young adults.Archives of Sexual Behavior 10/2011; 40(5):961-9. · 3.53 Impact Factor -
Article: A longitudinal analysis of predictors of male and female adolescents' transitions to intimate sexual behavior.
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ABSTRACT: Determining predictors of sexual transitions is essential for developing health interventions. Adolescents (13-16 years) completed baseline and 6-month surveys assessing psychosocial factors and sexual behavior. Lower self-esteem for boys and higher lifetime alcohol use for girls predicted transitions to more intimate sex. These differential profiles may warrant tailored health initiatives.Journal of Adolescent Health 09/2011; 49(3):321-3. · 3.33 Impact Factor -
Article: Gender differences in associations of sexual and romantic stimuli: do young men really prefer sex over romance?
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ABSTRACT: Theory and research emphasize differences in men's and women's sexual and romantic attitudes, concluding that men have stronger preferences for sexual than romantic stimuli as compared to women. However, most of the research on gender differences have relied on self-reports, which are plagued by problems of social desirability bias. The current study assessed young men's and women's implicit attitudes toward sexual and romantic stimuli to test whether, in fact, men have a stronger preference for sexual over romantic stimuli compared to women. We also assessed associations between implicit and explicit attitudes, as well as sex role ideology and personality. College students (68 men and 114 women) completed an Implicit Association Test (IAT) that assessed strengths of associations of sexual and romantic stimuli to both pleasant and unpleasant conditions. Results revealed that both men and women more strongly associated romantic images to the pleasant condition than they associated the sexual images to the pleasant condition. However, as predicted, women had a stronger preference toward romantic versus sexual stimuli compared to men. Our study challenges a common assumption that men prefer sexual over romantic stimuli. The findings indicate that measures of implicit attitudes may tap preferences that are not apparent in studies relying on self-reported (explicit) attitudes.Archives of Sexual Behavior 07/2011; 41(4):949-57. · 3.53 Impact Factor -
Article: Primary care providers' reports of time alone and the provision of sexual health services to urban adolescent patients: results of a prospective card study.
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ABSTRACT: Confidential care is an essential element of quality adolescent primary care. Twenty-one primary care providers tracked provision of confidential care (time alone with adolescent) and sexual health services in clinics serving low-income, primarily minority communities. Over 144 visits attended by a parent, 68% involved time alone with the adolescent. Time alone was 18 times higher for physicals than same day or walk-in visits, and 3 times higher if teen presented a sex complaint. Provision of sexual health services was 3 times higher for those who had time alone with the provider, especially among girls. The results indicate some missed opportunities to deliver needed services to at-risk populations, especially among boys.Journal of Adolescent Health 07/2010; 47(1):110-2. · 3.33 Impact Factor -
Article: In the absence of marriage: long-term concurrent partnerships, pregnancy, and HIV risk dynamics among South African young adults.
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ABSTRACT: In KwaZulu/Natal, South Africa, where HIV prevalence is among the world's highest, a longitudinal qualitative study of partnership dynamics and HIV preventive behaviors was conducted. 47 young adults aged 18-24 participated in in-depth interviews, and 29 were re-interviewed 2 years later. Five analytical domains emerged: primary partnerships, love and romance; secondary partnerships; pregnancy/parenthood; condom use/prevention; and contextual influences, including schooling and future aspirations. Primary relationships were long-lasting, with most men and women in the same relationship at 2-year follow-up. Secondary, casual partnerships were common for men and women, although these were shorter and changed frequently. Love and marriage aspirations were not viewed as incompatible with secondary partners. Condom use increased over time in some primary relationships, but decreased in others, and was nearly universal with non-primary partners. Pregnancy, school drop-out, and economic need strongly influence young people's lifecourse. These findings suggest the need to focus prevention efforts on the partnership context, including partner reduction, and structural factors that impede or enhance prevention success.AIDS and Behavior 03/2010; 14(5):991-1000. · 3.49 Impact Factor -
Article: Predicting first intercourse among urban early adolescent girls: The role of emotions
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ABSTRACT: Little is known about how girls perceive their ongoing or future sexual experiences, especially the emotions that they associate with these experiences. This study examined how early adolescent girls characterise first intercourse experiences in terms of positive and negative emotions over a one-year period. A US sample of 162 girls (12–14 years), primarily Latina and Black, completed two interviews one year apart that assessed sexual cognitions, affect, and behaviour. Girls anticipated primarily negative emotions associated with first intercourse, but recalled primarily positive emotions for first and recent intercourse experiences. In addition, girls’ emotion scores proved more useful than two types of cognitions (intentions and perceived readiness) and pre-intercourse sexual experience in predicting transitions to intercourse over the one-year period.Cognition and Emotion 01/2008; 22(1):168-179. · 2.52 Impact Factor -
Article: Such a tease: intentional sexual provocation within heterosexual interactions.
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ABSTRACT: Sexual teasing is a form of provocation characterized by the promise of sexual contact followed by withdrawal. The intention is to frustrate or cause tension in the target and incorporates some use of power of one person over another. To date, this form of interaction between individuals has received little research attention. A total of 742 undergraduate university students (143 men, 599 women) provided reports regarding whether they had ever engaged in sexual teasing and, for those who had, the motives behind this behavior, the type of relationship and sexual history with the target, and the reactions and outcomes associated with these interactions. Sexual teasing was relatively common among both women and men, although women were significantly more likely to report having engaged in sexual teasing at least once in the past. The outcomes associated with their interactions were perceived to be more positive for participants (elicitors) than for their targets, although relatively few participants reported more adverse outcomes from the use of sexual teasing. Discussion focused on the need to better characterize forms of communication regarding sexual intentions and consent. The findings may have implications for efforts to improve models of communication and negotiation in sexual interactions.Archives of Sexual Behavior 09/2007; 36(4):531-42. · 3.53 Impact Factor -
Article: I wanna hold your hand: the progression of social, romantic and sexual events in adolescent relationships.
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ABSTRACT: Despite the vast amount of existing research on adolescent sexual behavior, little is known about the trajectory of social, romantic and sexual events within an adolescent's relationship. A subsample of participants in Wave 2 of the National Longitudinal Study of Adolescent Health (8,438 respondents aged 12-21) provided data on the sequence of 15 social, romantic and sexual events that occurred in a recent romantic relationship. Proportions reporting each event and average relative rankings were assessed for all respondents, for different racial and ethnic groups, and for respondents who belonged to the same racial or ethnic group as their partner. Logistic regression was used to compare proportions; ordinary least square regression was used to analyze the mean sequential ranking of each event. Social and romantic events, such as spending time with one's partner in a group and holding hands, were far more common than sexual events, such as touching one's partner without clothing, and typically preceded sexual events in the trajectory of relationship events. Romantic events were the most common across three of the four major U.S. racial and ethnic groups. Asian and Hispanic respondents tended to have low proportions reporting sexual events compared with white respondents. Black adolescents were the only group for whom talking about prevention of pregnancy and STDs preceded sexual events. Reports from male and female adolescents were similar. Recognition of the diversity of relationship experiences may prompt the development of more effective interventions for adolescents who engage in risky sexual behavior.Perspectives on Sexual and Reproductive Health 07/2007; 39(2):100-7. · 1.41 Impact Factor -
Article: Awareness and attitudes regarding microbicides and Nonoxynol-9 use in a probability sample of gay men.
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ABSTRACT: A household probability sample of 879 adult gay and other men who have sex with men in San Francisco underwent phone interviews. Approximately, half reported recent unprotected anal intercourse (UAI). Yet, lubricant use was high, a behavior that may facilitate future adoption of topical microbicide delivered by a lubricant gel. Despite warnings against Nonoxynol-9 (N-9), 26% of respondents reported still using it. Microbicide awareness was higher among men reporting UAI than among consistent condom users. Scenarios presenting microbicides "as effective as condoms," "nearly as effective," or "less effective but better than nothing" produced wide variability in willingness to use them, which may have implications for microbicide acceptability. HIV-infected men and those who reported UAI showed greater microbicide acceptance.AIDS and Behavior 04/2007; 11(2):271-6. · 3.49 Impact Factor -
Article: Young urban adults' heterosexual risk encounters and perceived risk and safety: a structured diary study.
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ABSTRACT: Using diary methods, the current study explored characteristics of young adults' sexual risk interactions over a two-week period and the associations between perceived risk and safety with regard to these sexual risk behaviors. We screened all participants to ensure a moderate to high scores on an HIV knowledge measure. Men (n = 44) and women ( n = 48) enrolled at an inner-city college collected diary data, generating reports of 440 sexual occasions over a 2-week period (1,278 person-days). Despite participation in sexual risk activities, including highly inconsistent condom use during intercourse, participants uniformly reported high safety and little to no risk. Only women's perceptions of safety (not risk) were associated with condom use, men's perceptions of both safety and risk were unrelated. Ratings of safety and risk appeared to operate independently for the most part. Sex with new partners and new sexual activity were associated with both judgments of greater risk and lower safety were associated for men only. These results add to the growing evidence that young people fail to integrate fully their general knowledge regarding HIV risk into their personal interactions. This study has implications for the development of cognitive models around sexual decision-making for young adults at risk for HIV and may provide insight into the contextual features of sexual interactions associated with young people's perceptions of risk and safety.The Journal of Sex Research 12/2006; 43(4):343-51. · 2.53 Impact Factor -
Article: Gender role and relationship norms among young adults in South Africa: measuring the context of masculinity and HIV risk.
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ABSTRACT: In the global literature on HIV/AIDS, much attention has been paid to the role of gender inequalities in facilitating the transmission of HIV. For women, gender inequality may be manifested in sexual coercion, reduced negotiating power and partnering with older men, all practices that heighten risk for HIV. Less attention, however, has been paid to how men's relationship behaviors may place them at risk for HIV. Using six culturally specific psychometric scales developed in South Africa, this study examined men's and women's gender role and relationship norms, attitudes and beliefs in the context of ongoing partnerships. These measures were then examined in relation to four sexual risk behaviors: frequency of condom use (with primary or secondary partners) and number of partners (last 3 months and lifetime). Participants were 101 male and 199 female young adults aged, 18-24, recruited from a secondary school in northern KwaZulu/Natal province. Associations between gender and relationship scale scores and sexual risk outcomes yielded both expected and contradictory findings. For men, more frequent condom use was associated with higher levels of partner attachment (hyper-romanticism) but also with stronger approval of relationship violence and dominant behavior. In contrast, for women, more frequent condom use was correlated with a lower endorsement of relationship violence. Men with lower relationship power scores had fewer sexual partners in the preceding 3 months, while women with more egalitarian sexual scripts reported more sexual partners, as did those with higher hyper-romanticism scores. In logistic regression analysis, more egalitarian relationship norms among men were predictive of less consistent condom use, as were higher relationship power scores for women. These findings are discussed in relation to previous research on gender, heterosexual interactions and masculinity in this area, as well as the implications for HIV prevention programs.Journal of Urban Health 08/2006; 83(4):709-22. · 2.13 Impact Factor -
Article: Men, multiple sexual partners, and young adults' sexual relationships: understanding the role of gender in the study of risk.
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ABSTRACT: Heterosexual transmission of HIV and other sexually transmitted infections has become a primary health concern worldwide. Gender roles for heterosexual interactions appear to sanction men's sexual risk-taking, especially the pursuit of multiple sexual partners. Using measures developed in this study, the current study assessed the associations between men's and women's relationship attitudes and experiences and their sexual risk encounters. Participants were 104 men and 103 women (18-24 years) from a large, urban college located in a high HIV risk neighborhood of New York City. All completed a survey assessing HIV risk and the battery of relationship measures assessing traditional sexual roles, sexual conflicts, significance of sex, relationship investment, need for relationship, and unwanted sex. For men, greater sexual conflict in their primary relationships was associated with more sexual partners and fewer unprotected vaginal intercourse encounters with a primary partner and across sex partners overall. In addition, men's endorsement of more traditional sexual roles and lower relationship investment were associated with higher numbers of sexual partners. Among women, compliance with men to engage in unwanted sex was associated with higher levels of participation in unprotected sex. For both men and women, greater significance given to sex in a relationship was associated with fewer extradyadic partners. This study demonstrates the utility of measures of relationship attitudes and experiences to characterize sexual risk, especially among men. Findings are discussed in terms of implications for prevention program targeting young urban adults.Journal of Urban Health 08/2006; 83(4):695-708. · 2.13 Impact Factor -
Article: The timing of changes in girls' sexual cognitions and behaviors in early adolescence: a prospective, cohort study.
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ABSTRACT: This small, prospective cohort study of 162 12- to 15-year-old girls examines timing of changes in sexual cognitions and behaviors (breast fondling, genital contact, and sexual intercourse) over a 1-year period. Girls from community sites in New York City provided information about sexual experiences and related cognitions (arousability, sexual agency, abstinence attitudes, perceived parental and peer approval, and sexual self-esteem) in 2 interviews 1 year apart. Percentages who reported breast fondling, genital contact, and sexual intercourse (18%, 24%, and 6%) increased significantly over the year (42%, 44%, and 19%) and with age. For each behavior, analyses compared girls who did not report the behavior at either Time 1 or 2, those who reported by Time 2 but not 1, or those who reported at both time points. Girls with no breast fondling experience at either time point had stronger abstinence values, and lower arousability, agency, peer approval, and sexual self-esteem scores compared to girls who initiated breast fondling over the year (transitioners). Transitioners were markedly similar in sexual cognitions to girls with this experience before Time 1, suggesting that changes in sexual cognitions precede actual experience. A similar pattern was found between groups for genital contact. Few differences between groups by comparison were noted for sexual intercourse, which occurs later in the trajectory. Sexual experiences that occur before intercourse (e.g., breast fondling) are central to research on sexual development and related to greater changes in girls' sexual cognitions than is intercourse. Changes in cognitions precede, rather than follow, new sexual experiences.Journal of Adolescent Health 10/2005; 37(3):211-9. · 3.33 Impact Factor -
Article: Intimate partner violence and monogamy among women in methadone treatment.
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ABSTRACT: It is now becoming clear how important it is to understand women's HIV risk in the context of their sexual relationships with male partners, particularly among more vulnerable populations of women such as drug-involved women and women with physically abusive partners. Drawing from in-depth interviews with a sample of 38 ethnically diverse women, this study explores the meanings of monogamy and concurrent sexual partnerships in the relationships of women in methadone treatment with a history of physical abuse. Moreover, the ways in which having a history of intimate partner violence influences women's desire and ability to insist on monogamy is addressed. The women's narratives indicated that the majority valued monogamy and reported practicing it; however, many women were indifferent to this ideal or were unable to challenge non-monogamous partners for fear of severe reprisals. In addition, men's suspicions about violations of monogamy on the part of the women often resulted in extreme violence.AIDS and Behavior 07/2005; 9(2):177-86. · 3.49 Impact Factor -
Article: Assessing reliability of early adolescent girls' reports of romantic and sexual behavior.
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ABSTRACT: Increasing rates of HIV among urban adolescents have raised concerns about their participation in sexual risk behaviors. The accuracy of adolescents' sexual reports is critical to the assessment of risk, which may later guide the development of public policy, interventions, and education efforts. The data presented here are part of a larger study on a range of sexual behaviors and cognitions believed to be important regarding adolescent girls' sexual choices and decision-making. Our goal here was to assess the test-retest reliability of early adolescent girls' reports of their romantic and sexual experiences. This information will contribute to our limited information base regarding sexuality research with early adolescents. Fifty urban African American and Latina girls between the ages of 12 and 14 years were recruited from community settings around New York City. A battery of sexual behavior and sexual cognition measures was administered by interviewers at two time points separated by a 3-week interval. Results indicated that the girls were highly reliable in reporting their sexual experiences, especially those experiences related to age of first romantic and sexual milestone experiences.Archives of Sexual Behavior 01/2004; 32(6):513-21. · 3.53 Impact Factor -
Article: Sibling influence, gender roles, and the sexual socialization of urban early adolescent girls.
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ABSTRACT: This study examined whether older siblings influence early adolescent girls' sexual socialization. Participants were 180 girls, 12 to 14-years-old, from predominantly ethnic minority backgrounds. They completed a battery of interviewer-administered measures assessing a range of sexual cognitions and romantic and sexual behaviors. As predicted, compared with other girls, girls with older brothers placed greater value in becoming a parent, had lower levels of sexual responsivity or interest, and reported smaller age discrepancies between themselves and their partners for their first romantic kiss. Regardless of sibling sex, having older siblings was associated with more restrictive sexual cognitions and behaviors. Findings are interpreted in the context of sexual script theory.The Journal of Sex Research 03/2003; 40(1):101-10. · 2.53 Impact Factor -
Article: Gender dynamics in the primary sexual relationships of young rural South African women and men.
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ABSTRACT: A substantial body of South African research describes the importance of gender dynamics within sexual relationships as factors underlying HIV risk, yet we know little about these factors among young adults-a group at exceptionally high risk of infection. Our primary objective was to explore the ways that young adult men and women interpret and enact gender roles within their established primary partnerships, and how these dynamics influence sexual behaviour in relation to HIV risk. We employed script theory to frame our analysis of the dynamics of gender. Fifty students (25 women, 25 men) at secondary schools in a rural district of KwaZulu/Natal, South Africa completed in-depth interviews about sexual interactions with their primary partner. While many participants indicated that the standards of sexual conduct within relationships reflect dominant gender role norms, our findings indicate that there are important variations in these roles with some male and female respondents accepting and reinforcing the rights of women to determine the nature of sexual interactions. Efforts aimed at improving acceptance and adoption of alternative scripts for women and men may help to broaden young people's repertoire of HIV prevention options.Culture Health & Sexuality 8(2):99-113. · 1.55 Impact Factor -
Article: Perspectives on confidential care for adolescent girls.
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ABSTRACT: We wanted to obtain perspectives of mothers and daughters on facilitators of and barriers to with adolescent girls' timely access to risk-appropriate reproductive care. We conducted 5 separate focus groups with Latina and black mothers and their adolescent daughters. All participants resided in impoverished neighborhoods of New York City. Participants addressed mothers' roles in helping girls initiate gynecologic care, perceived role of physicians in daughters' sexual health, including the provision of confidential care, and perceived need for girls' gynecologic care. Data were analyzed using qualitative data analysis methods. Mothers see themselves as their daughters' primary protectors against daughters' poor reproductive outcomes. Many believe that confidential care promotes risky behavior and undermines mothers' efforts to protect girls. Mothers endorse facilitating gynecologic care and entering alliances with physicians but see the need for care as arising only after girls' sexual debut. Unfortunately, maternal awareness of sexual activity is low. Adolescent girls express considerable discomfort around reproductive health care and negotiating maternal involvement, and they fear breaches in confidentiality. A lack of trust in health care clinicians and the mother's gatekeeper role are key barriers to girls' transition to reproductive care. Consistently including a confidential component to health care visits in early adolescence, with preparation for both mothers and daughters, may reduce the distrust and discomfort.The Annals of Family Medicine 4(6):519-26. · 5.36 Impact Factor -
Article: Challenges of providing confidential care to adolescents in urban primary care: clinician perspectives.
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ABSTRACT: Clinician time alone with an adolescent has a major impact on disclosure of risk behavior. This study sought to describe primary care clinicians' patterns of delivering time alone, decision making about introducing time alone to adolescents and their parents, and experiences delivering confidential services. We undertook qualitative interviews with 18 primary care clinicians in urban health centers staffed by specialists in pediatrics, family medicine, and adolescent medicine. The annual preventive care visit is the primary context for provision of time alone with adolescents; clinicians consider the parent-child dynamic and the nature of the chief complaint for including time alone during visits for other than preventive care. Time constraints are a major barrier to offering time alone more frequently. Clinicians perceive that parental discomfort with time alone is rare. Many clinicians wrestle with internal conflict about providing confidential services to adolescents with serious health threats and regard their role as facilitating adolescent-parent communication. Health systems factors can interfere with delivery of confidential services, such as inconsistent procedures for determining whether unaccompanied youth would be seen. Despite competing time demands, clinicians report commitment to offering time alone during preventive care visits and infrequently offer it at other times. Experienced clinicians can gain skills in the art of managing complex relationships between adolescents and their parents. Office systems should be developed that enhance the consistency of delivery of confidential services.The Annals of Family Medicine 9(1):37-43. · 5.36 Impact Factor
Top co-authors
Top Journals
Institutions
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2007–2012
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University of New Brunswick
- Department of Psychology
Fredericton, New Brunswick, Canada -
University of Texas at Austin
- Department of Psychology
Texas City, TX, USA
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2010
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Brown University
Providence, RI, USA
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2006
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Albert Einstein College of Medicine
- Department of Family & Social Medicine
New York City, NY, USA
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2005
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Columbia University
- College of Physicians and Surgeons
New York City, NY, USA
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2003
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Long Island University
New York City, NY, USA
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