Laura Salazar - Academia.edu (original) (raw)

Papers by Laura Salazar

Ethnicity Disease, 2011

Objectives-Cell phones and online media are used frequently but we know little about their use am... more Objectives-Cell phones and online media are used frequently but we know little about their use among African American adolescents. This study examines the frequency of such use and its relationship to psychosocial variables and STI/HIV risk behavior.

Http Dx Doi Org 10 1080 00224499 2011 636845, Jan 23, 2013

Abstract The purpose of this study was to develop and assess the psychometric properties of sever... more Abstract The purpose of this study was to develop and assess the psychometric properties of several scales that measure dyadic constructs derived from an integrated model of interdependence theory and communal coping perspectives. The scales are specific to ...

Sex Transm Infect, 2006

Objective: To identify whether school enrolment is protective against laboratory-confirmed diagno... more Objective: To identify whether school enrolment is protective against laboratory-confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors. Methods: A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included an audio-computer-assisted self-interview lasting about 60 min and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. Results: In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance. Conclusion: This study provides initial evidence suggesting that keeping high-risk African-American adolescent females in school (including forms of school that occur after high-school graduation) may be important from a public health standpoint.

ABSTRACT Background: A growing body of research suggests sexual identity stigma contributes to in... more ABSTRACT Background: A growing body of research suggests sexual identity stigma contributes to inequitable patterns of HIV risk among men who have sex with men (MSM). Despite substantial racial disparities in HIV infection among MSM, few studies have examined racial differences in the prevalence of and factors associated with sexual identity stigma. Methods: Data come from a cohort of 454 black MSM and 349 white MSM recruited in Atlanta between July 2010 and December 2012. Sexual identity stigma was measured as the sum score from a seven-item Likert scale (range: 7-35). We used multiple linear regression models to understand the relationship between stigma and participant characteristics and neighborhood perceptions within separate black and white subgroups and among the total sample. Results: Black MSM reported significantly higher sexual identity stigma than white MSM (mean: 18.6 vs. 16.8, p<0.01). Among both white MSM and the total unstratified sample, lower perceived neighborhood quality (p<0.03), less connectedness to the gay community (p<0.01), and increased racial stigma (p<0.01) were associated with increased sexual identity stigma. Among black MSM, younger age (p=0.02), non-gay sexual identity (p=0.03), less connectedness to the gay community (p<0.01), and increased racial stigma (p<0.01) were associated with increased sexual identity stigma. Conclusions: MSM with multiple minority statuses (e.g., non-gay-identified black MSM) may experience an increased burden of sexual identity stigma. Interventions designed to reduce stigma or address its effects among MSM should acknowledge the potential for disparate experiences related to sexual identity stigma, racism, and neighborhood perceptions among diverse MSM subgroups.

Adolescence an International Quarterly Devoted to the Physiological Psychological Psychiatric Sociological and Educational Aspects of the Second Decade of Human Life, Feb 1, 2008

Condom use at last sex is a widely used indicator in sexual behavior research; however, there is ... more Condom use at last sex is a widely used indicator in sexual behavior research; however, there is little empirical research validating this indicator. This study examined whether a single-event recall period (the last time coitus occurred) was consistent with longer recall periods (14 days and 60 days) for a sample of African American adolescent females (N = 566). The findings from this study demonstrate that condom use at last coitus is a valid proxy for condom use behaviors spanning longer time periods.

Adolescence San Diego, Feb 1, 2005

The purpose of this research was to identify environmental factors that influence incarcerated ad... more The purpose of this research was to identify environmental factors that influence incarcerated adolescents' risk for HIV/STDs. Based on data from six gender-stratified focus groups consisting of 28 incarcerated adolescents from three detention centers in Georgia, the following salient environments emerged: schools, families, peer groups, neighborhoods, malls, and detention centers. These environments represent places in which factors related to sexual decision-making are embedded for this high-risk population. Within these environments, five factors influence their risk for HIV/STDs: (1) hierarchical messages that promote abstinence and risk reduction, (2) availability and accessibility of condoms, (3) acceptability of condoms, (4) availability of comprehensive sex education, and (5) parental communication about sex and risk reduction. Increased understanding of the role of these factors may contribute to the development of integrated interventions designed to prevent HIV/STDs among incarcerated adolescents.

American Journal of Preventive Medicine, May 2, 2015

To identify the prevalence of health risk factors among a sample of detained adolescent females a... more To identify the prevalence of health risk factors among a sample of detained adolescent females and determine whether there are racial/ethnic differences.

Http Dx Doi Org 10 1080 13548506 2012 726361, May 2, 2013

This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infectio... more This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infections among detained African American female adolescents. A cross-sectional survey was conducted among 123 African American female adolescents within eight detention facilities in Georgia. Using audio-computer assisted self-interviewing technology, data were collected on demographics, ethnic identity, laboratory-confirmed Chlamydia and Gonorrhea, and other known correlates for sexually transmitted infections (STIs), such as socioeconomic status, parental monitoring, and risky sexual behaviors. Rates of Chlamydia and Gonorrhea testing yielded incidence rates of 22.6% and 4.3%, respectively. Findings indicated that, controlling for STI correlates, participants who indicated high ethnic identity were 4.3 times more likely to test positive for an STI compared to those scoring low on the measure of ethnic identity.

To assess children's and parents&... more To assess children's and parents' attitudes regarding pediatric research that poses minimal risk or a minor increase over minimal risk and does not offer the potential to benefit the child clinically. Separate in-person interviews with children and their parents. Clinics where the children were receiving clinical care or participating in clinical research for asthma or cancer. Children aged 7 to 14 years and their parents or legal guardians. In-person interviews. Respondents' willingness to enroll the child in nonbeneficial research and charitable activities that posed the same risks. Overall, 81 child-parent pairs were interviewed. For a hypothetical study that would not benefit the child and posed a risk of headache, 71% of the children were willing to participate, and 72% of the parents would allow their children to participate. For a hypothetical study that would not benefit the child and posed a very small chance of a broken leg, 43% of the children and 24% of the parents endorsed the child's participation. Overall, respondents were equally willing to have the child help others by participating in nonbeneficial research or by participating in a charitable activity. Most respondents were willing to have the child participate in some nonbeneficial research, and most did not consider nonbeneficial pediatric research to be more problematic than charitable activities for children. These findings provide empirical data to support the acceptability of exposing children to some research risks for the benefit of others.

ABSTRACT Purpose: The purpose of this study is to identify significant predictors of high sexuall... more ABSTRACT Purpose: The purpose of this study is to identify significant predictors of high sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) prevention knowledge among African American adolescent girls. Based on the information, motivation and behavior (IMB) model, high STI knowledge can directly reduce sexual risk behaviors (Fisher & Fisher, 1992). However, there is a dearth of research that examines factors associated with sexual knowledge among African American girls as most studies have focused on factors that are predictive of risky sexual behaviors, which though important represents a different outcome and set of potential correlates. Therefore, utilizing an ecological approach, this study examines factors related to STI/HIV knowledge. Findings can provide promising points and content for STI intervention that are targeted at African American girls. Methods: Participants were African American females ages 15 to 21 (n=715) that were recruited from clinics that provide sexual health services to predominantly inner-city adolescents in downtown Atlanta, Georgia. All respondents had reported sexual activity in the previous 60 days. Sexual knowledge was constructed from a series of 11 questions that tested the accuracy of their STI prevention knowledge. In addition, based on the literature, potential factors that can influence sexual knowledge were identified and organized using Bronfenbrenner's (1979) ecological model. Variables analyzed in the study included age, self-efficacy, age of sexual partner, family structure, attendance at sex education classes, neighborhood quality and socioeconomic status. All data was assessed using computer-assisted interviewing techniques. Stepwise regression techniques were used to identify factors that are most predictive of sexual knowledge. Results: The hypothesized correlates of sexual knowledge were in the anticipated directions. A higher number of sexual partners and neighborhood quality was positively correlated with sexual knowledge. Additionally, lower self efficacy and staying with someone other than both parents were negatively associated with sexual knowledge. Subsequently in the stepwise regression models, three variables retained significance. Number of sexual partners was positively related to sexual knowledge (p ≤ 0.05); self mastery positively related to knowledge (p ≤ 0.001). However, living with someone other than both mother and father was inversely related to sexual knowledge (p ≤ 0.05). Implications: Findings provide important points for intervention. For instance, male sexual partners are an important source for STI/HIV prevention information and might be targeted for inclusion in interventions for their female counterparts. Lastly, STI interventions targeting African American girls should also go beyond the impartation of knowledge to enhancing self worth to encourage the application of STI/HIV prevention information.

Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitte... more Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial (N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes (p < .05). Parental monitoring was an effect modifier for the perceived peer norms and lifetime sexual partners association (p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.

Health Education Research, Aug 1, 2010

This study sought to determine the perspective taken toward understanding adolescent sexual risk ... more This study sought to determine the perspective taken toward understanding adolescent sexual risk behaviors and related biological outcomes (i.e. pregnancy, sexually transmitted diseases) since 1990. We content analyzed 324 abstracts representing observational research published between January 1990 and December 2007 for inclusion of ecological (environmental) factors, level of analysis, sample composition and type of behavioral and biological outcomes. A majority (95%) of studies included individual characteristics; half were void of any environmental factors. Of those including environmental factors, 27% included familial, 23% community, 13% relational and 3% societal factors. Most (80%) were positioned at the individual level of analysis. Samples were diverse (43%) and of mixed gender (71%). Biomarkers of sexually transmitted diseases (7.5%) or pregnancy outcomes (2%) were rare. Ecological inclusion was not related to year of publication. Despite the rhetoric highlighting, the importance of an ecological perspective in understanding adolescent sexual risk behavior, much published research, excludes environmental influences.

Journal of the International Association of Providers of Aids Care, Mar 1, 2014

We tested a couples HIV testing and counseling (CHTC) intervention with male couples in Atlanta b... more We tested a couples HIV testing and counseling (CHTC) intervention with male couples in Atlanta by randomizing eligible couples to receive either CHTC or separate individual voluntary HIV counseling and testing (iVCT). To evaluate the acceptability and safety of CHTC, main outcomes were satisfaction with the intervention and the proportions of couples reporting intimate partner violence (IPV) and relationship dissolution after the service. The results indicated that the service was very acceptable to men (median 7-item index of satisfaction was 34 for CHTC and 35 for iVCT, P = .4). There was no difference in either incident IPV (22% versus 17% for CHTC and iVCT, respectively, P = .6) or relationship dissolution (42% versus 51% for CHTC and iVCT, respectively, P = .5). Based on the preliminary data, CHTC is safe for male couples, and it is equally acceptable to iVCT for men who have main partners.

Aids, Jun 1, 2009

Background: HIV incidence in the United States among men who have sex with men (MSM) has been inc... more Background: HIV incidence in the United States among men who have sex with men (MSM) has been increasing since 2000, and MSM remain the most heavily impacted risk group in the US HIV epidemic.

Western Journal of Emergency Medicine, 2011

Objectives: African-American women are affected by disproportionately high rates of violence and ... more Objectives: African-American women are affected by disproportionately high rates of violence and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) infection. It is imperative to address the intersection of these two urgent public health issues, particularly as these affect African-American adolescent girls. This study assessed the prevalence of rape victimization (RV) among a sample of African-American adolescent females and examined the extent to which participants with a history of RV engage in STI/HIV associated risk behaviors over a 12-month time period.

American Journal of Public Health, Dec 1, 2009

Sexual Health, Apr 27, 2015

International Journal of Std Aids, Oct 1, 2010

This study determined whether bisexual male injecting drug users (IDUs) as compared with heterose... more This study determined whether bisexual male injecting drug users (IDUs) as compared with heterosexual IDUs were more likely to engage in HIV-associated risk behaviours. Respondent-driven sampling was employed to recruit a sample of 382 male IDUs residing in the southeastern USA. Data were collected in face-to-face interviews. Weighted analyses showed that bisexual IDUs in the past 12 months were 4.6 times as likely to share needles and 3.5 times as likely to share a cooker; having multiple female sexual partners and trading money or drugs for sex with women were marginally significant. Bisexual IDUs were 10 times as likely to self-report HIV. Male IDUs, who engage in bisexual behaviour, are also engaging in HIV-associated drug and to some degree sexual-risk behaviours with women more so than heterosexual IDUs. Their higher prevalence of HIV infection coupled with their risk behaviours place themselves and other IDUs at heightened risk of both acquiring and transmitting HIV.

Journal of Hiv Aids Prevention in Children Youth, Jul 20, 2007

Abstract This paper reports on three studies in which the Partner Communication Scale (PCS) is va... more Abstract This paper reports on three studies in which the Partner Communication Scale (PCS) is validated. The PCS assesses African American adolescent females' frequency of sexual communication with male sex partners. The PCS was administered to three samples of African American female adolescents (N= 522; N= 280; N= 715) ranging in age from 14 to 21. The PCS demonstrated strong internal consistency and acceptable stability over 6-month and 12-month follow-up periods. Scores on the PCS were correlated with ...

Ethnicity Disease, 2011

Objectives-Cell phones and online media are used frequently but we know little about their use am... more Objectives-Cell phones and online media are used frequently but we know little about their use among African American adolescents. This study examines the frequency of such use and its relationship to psychosocial variables and STI/HIV risk behavior.

Http Dx Doi Org 10 1080 00224499 2011 636845, Jan 23, 2013

Abstract The purpose of this study was to develop and assess the psychometric properties of sever... more Abstract The purpose of this study was to develop and assess the psychometric properties of several scales that measure dyadic constructs derived from an integrated model of interdependence theory and communal coping perspectives. The scales are specific to ...

Sex Transm Infect, 2006

Objective: To identify whether school enrolment is protective against laboratory-confirmed diagno... more Objective: To identify whether school enrolment is protective against laboratory-confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors. Methods: A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included an audio-computer-assisted self-interview lasting about 60 min and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. Results: In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance. Conclusion: This study provides initial evidence suggesting that keeping high-risk African-American adolescent females in school (including forms of school that occur after high-school graduation) may be important from a public health standpoint.

ABSTRACT Background: A growing body of research suggests sexual identity stigma contributes to in... more ABSTRACT Background: A growing body of research suggests sexual identity stigma contributes to inequitable patterns of HIV risk among men who have sex with men (MSM). Despite substantial racial disparities in HIV infection among MSM, few studies have examined racial differences in the prevalence of and factors associated with sexual identity stigma. Methods: Data come from a cohort of 454 black MSM and 349 white MSM recruited in Atlanta between July 2010 and December 2012. Sexual identity stigma was measured as the sum score from a seven-item Likert scale (range: 7-35). We used multiple linear regression models to understand the relationship between stigma and participant characteristics and neighborhood perceptions within separate black and white subgroups and among the total sample. Results: Black MSM reported significantly higher sexual identity stigma than white MSM (mean: 18.6 vs. 16.8, p<0.01). Among both white MSM and the total unstratified sample, lower perceived neighborhood quality (p<0.03), less connectedness to the gay community (p<0.01), and increased racial stigma (p<0.01) were associated with increased sexual identity stigma. Among black MSM, younger age (p=0.02), non-gay sexual identity (p=0.03), less connectedness to the gay community (p<0.01), and increased racial stigma (p<0.01) were associated with increased sexual identity stigma. Conclusions: MSM with multiple minority statuses (e.g., non-gay-identified black MSM) may experience an increased burden of sexual identity stigma. Interventions designed to reduce stigma or address its effects among MSM should acknowledge the potential for disparate experiences related to sexual identity stigma, racism, and neighborhood perceptions among diverse MSM subgroups.

Adolescence an International Quarterly Devoted to the Physiological Psychological Psychiatric Sociological and Educational Aspects of the Second Decade of Human Life, Feb 1, 2008

Condom use at last sex is a widely used indicator in sexual behavior research; however, there is ... more Condom use at last sex is a widely used indicator in sexual behavior research; however, there is little empirical research validating this indicator. This study examined whether a single-event recall period (the last time coitus occurred) was consistent with longer recall periods (14 days and 60 days) for a sample of African American adolescent females (N = 566). The findings from this study demonstrate that condom use at last coitus is a valid proxy for condom use behaviors spanning longer time periods.

Adolescence San Diego, Feb 1, 2005

The purpose of this research was to identify environmental factors that influence incarcerated ad... more The purpose of this research was to identify environmental factors that influence incarcerated adolescents' risk for HIV/STDs. Based on data from six gender-stratified focus groups consisting of 28 incarcerated adolescents from three detention centers in Georgia, the following salient environments emerged: schools, families, peer groups, neighborhoods, malls, and detention centers. These environments represent places in which factors related to sexual decision-making are embedded for this high-risk population. Within these environments, five factors influence their risk for HIV/STDs: (1) hierarchical messages that promote abstinence and risk reduction, (2) availability and accessibility of condoms, (3) acceptability of condoms, (4) availability of comprehensive sex education, and (5) parental communication about sex and risk reduction. Increased understanding of the role of these factors may contribute to the development of integrated interventions designed to prevent HIV/STDs among incarcerated adolescents.

American Journal of Preventive Medicine, May 2, 2015

To identify the prevalence of health risk factors among a sample of detained adolescent females a... more To identify the prevalence of health risk factors among a sample of detained adolescent females and determine whether there are racial/ethnic differences.

Http Dx Doi Org 10 1080 13548506 2012 726361, May 2, 2013

This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infectio... more This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infections among detained African American female adolescents. A cross-sectional survey was conducted among 123 African American female adolescents within eight detention facilities in Georgia. Using audio-computer assisted self-interviewing technology, data were collected on demographics, ethnic identity, laboratory-confirmed Chlamydia and Gonorrhea, and other known correlates for sexually transmitted infections (STIs), such as socioeconomic status, parental monitoring, and risky sexual behaviors. Rates of Chlamydia and Gonorrhea testing yielded incidence rates of 22.6% and 4.3%, respectively. Findings indicated that, controlling for STI correlates, participants who indicated high ethnic identity were 4.3 times more likely to test positive for an STI compared to those scoring low on the measure of ethnic identity.

To assess children's and parents&... more To assess children's and parents' attitudes regarding pediatric research that poses minimal risk or a minor increase over minimal risk and does not offer the potential to benefit the child clinically. Separate in-person interviews with children and their parents. Clinics where the children were receiving clinical care or participating in clinical research for asthma or cancer. Children aged 7 to 14 years and their parents or legal guardians. In-person interviews. Respondents' willingness to enroll the child in nonbeneficial research and charitable activities that posed the same risks. Overall, 81 child-parent pairs were interviewed. For a hypothetical study that would not benefit the child and posed a risk of headache, 71% of the children were willing to participate, and 72% of the parents would allow their children to participate. For a hypothetical study that would not benefit the child and posed a very small chance of a broken leg, 43% of the children and 24% of the parents endorsed the child's participation. Overall, respondents were equally willing to have the child help others by participating in nonbeneficial research or by participating in a charitable activity. Most respondents were willing to have the child participate in some nonbeneficial research, and most did not consider nonbeneficial pediatric research to be more problematic than charitable activities for children. These findings provide empirical data to support the acceptability of exposing children to some research risks for the benefit of others.

ABSTRACT Purpose: The purpose of this study is to identify significant predictors of high sexuall... more ABSTRACT Purpose: The purpose of this study is to identify significant predictors of high sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) prevention knowledge among African American adolescent girls. Based on the information, motivation and behavior (IMB) model, high STI knowledge can directly reduce sexual risk behaviors (Fisher & Fisher, 1992). However, there is a dearth of research that examines factors associated with sexual knowledge among African American girls as most studies have focused on factors that are predictive of risky sexual behaviors, which though important represents a different outcome and set of potential correlates. Therefore, utilizing an ecological approach, this study examines factors related to STI/HIV knowledge. Findings can provide promising points and content for STI intervention that are targeted at African American girls. Methods: Participants were African American females ages 15 to 21 (n=715) that were recruited from clinics that provide sexual health services to predominantly inner-city adolescents in downtown Atlanta, Georgia. All respondents had reported sexual activity in the previous 60 days. Sexual knowledge was constructed from a series of 11 questions that tested the accuracy of their STI prevention knowledge. In addition, based on the literature, potential factors that can influence sexual knowledge were identified and organized using Bronfenbrenner's (1979) ecological model. Variables analyzed in the study included age, self-efficacy, age of sexual partner, family structure, attendance at sex education classes, neighborhood quality and socioeconomic status. All data was assessed using computer-assisted interviewing techniques. Stepwise regression techniques were used to identify factors that are most predictive of sexual knowledge. Results: The hypothesized correlates of sexual knowledge were in the anticipated directions. A higher number of sexual partners and neighborhood quality was positively correlated with sexual knowledge. Additionally, lower self efficacy and staying with someone other than both parents were negatively associated with sexual knowledge. Subsequently in the stepwise regression models, three variables retained significance. Number of sexual partners was positively related to sexual knowledge (p ≤ 0.05); self mastery positively related to knowledge (p ≤ 0.001). However, living with someone other than both mother and father was inversely related to sexual knowledge (p ≤ 0.05). Implications: Findings provide important points for intervention. For instance, male sexual partners are an important source for STI/HIV prevention information and might be targeted for inclusion in interventions for their female counterparts. Lastly, STI interventions targeting African American girls should also go beyond the impartation of knowledge to enhancing self worth to encourage the application of STI/HIV prevention information.

Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitte... more Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial (N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes (p < .05). Parental monitoring was an effect modifier for the perceived peer norms and lifetime sexual partners association (p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.

Health Education Research, Aug 1, 2010

This study sought to determine the perspective taken toward understanding adolescent sexual risk ... more This study sought to determine the perspective taken toward understanding adolescent sexual risk behaviors and related biological outcomes (i.e. pregnancy, sexually transmitted diseases) since 1990. We content analyzed 324 abstracts representing observational research published between January 1990 and December 2007 for inclusion of ecological (environmental) factors, level of analysis, sample composition and type of behavioral and biological outcomes. A majority (95%) of studies included individual characteristics; half were void of any environmental factors. Of those including environmental factors, 27% included familial, 23% community, 13% relational and 3% societal factors. Most (80%) were positioned at the individual level of analysis. Samples were diverse (43%) and of mixed gender (71%). Biomarkers of sexually transmitted diseases (7.5%) or pregnancy outcomes (2%) were rare. Ecological inclusion was not related to year of publication. Despite the rhetoric highlighting, the importance of an ecological perspective in understanding adolescent sexual risk behavior, much published research, excludes environmental influences.

Journal of the International Association of Providers of Aids Care, Mar 1, 2014

We tested a couples HIV testing and counseling (CHTC) intervention with male couples in Atlanta b... more We tested a couples HIV testing and counseling (CHTC) intervention with male couples in Atlanta by randomizing eligible couples to receive either CHTC or separate individual voluntary HIV counseling and testing (iVCT). To evaluate the acceptability and safety of CHTC, main outcomes were satisfaction with the intervention and the proportions of couples reporting intimate partner violence (IPV) and relationship dissolution after the service. The results indicated that the service was very acceptable to men (median 7-item index of satisfaction was 34 for CHTC and 35 for iVCT, P = .4). There was no difference in either incident IPV (22% versus 17% for CHTC and iVCT, respectively, P = .6) or relationship dissolution (42% versus 51% for CHTC and iVCT, respectively, P = .5). Based on the preliminary data, CHTC is safe for male couples, and it is equally acceptable to iVCT for men who have main partners.

Aids, Jun 1, 2009

Background: HIV incidence in the United States among men who have sex with men (MSM) has been inc... more Background: HIV incidence in the United States among men who have sex with men (MSM) has been increasing since 2000, and MSM remain the most heavily impacted risk group in the US HIV epidemic.

Western Journal of Emergency Medicine, 2011

Objectives: African-American women are affected by disproportionately high rates of violence and ... more Objectives: African-American women are affected by disproportionately high rates of violence and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) infection. It is imperative to address the intersection of these two urgent public health issues, particularly as these affect African-American adolescent girls. This study assessed the prevalence of rape victimization (RV) among a sample of African-American adolescent females and examined the extent to which participants with a history of RV engage in STI/HIV associated risk behaviors over a 12-month time period.

American Journal of Public Health, Dec 1, 2009

Sexual Health, Apr 27, 2015

International Journal of Std Aids, Oct 1, 2010

This study determined whether bisexual male injecting drug users (IDUs) as compared with heterose... more This study determined whether bisexual male injecting drug users (IDUs) as compared with heterosexual IDUs were more likely to engage in HIV-associated risk behaviours. Respondent-driven sampling was employed to recruit a sample of 382 male IDUs residing in the southeastern USA. Data were collected in face-to-face interviews. Weighted analyses showed that bisexual IDUs in the past 12 months were 4.6 times as likely to share needles and 3.5 times as likely to share a cooker; having multiple female sexual partners and trading money or drugs for sex with women were marginally significant. Bisexual IDUs were 10 times as likely to self-report HIV. Male IDUs, who engage in bisexual behaviour, are also engaging in HIV-associated drug and to some degree sexual-risk behaviours with women more so than heterosexual IDUs. Their higher prevalence of HIV infection coupled with their risk behaviours place themselves and other IDUs at heightened risk of both acquiring and transmitting HIV.

Journal of Hiv Aids Prevention in Children Youth, Jul 20, 2007

Abstract This paper reports on three studies in which the Partner Communication Scale (PCS) is va... more Abstract This paper reports on three studies in which the Partner Communication Scale (PCS) is validated. The PCS assesses African American adolescent females' frequency of sexual communication with male sex partners. The PCS was administered to three samples of African American female adolescents (N= 522; N= 280; N= 715) ranging in age from 14 to 21. The PCS demonstrated strong internal consistency and acceptable stability over 6-month and 12-month follow-up periods. Scores on the PCS were correlated with ...