Relationship characteristics and feelings about pregnancy among black and puerto rican young adults.

CONTEXT: Unintended pregnancy is common among black and Hispanic young adults in the United States. How pregnancy intentions form and change is poorly understood, although research indicates that intentions and attitudes are dependent on partners' views and other relationship factors, and are different by gender. METHODS: A sample of black and Puerto Rican men and women aged 18-25 from low-income neighborhoods in two cities were surveyed in 2007-2008. Using data on 520 serious and casual sexual relationships reported by 460 respondents, generalized ordered logistic regression analysis was conducted to identify individual- and relationship-level correlates of how respondents would feel if they became involved in a pregnancy with a particular partner. RESULTS: About one-quarter of respondents reported each of four possibilities of how they would feel about a pregnancy with a particular partner-very upset, a little upset, a little pleased and very pleased. In 45% of relationships, respondents believed that their partners would be very pleased about a pregnancy, whereas they themselves would be very pleased in only one-quarter of cases. Overall, women were less likely to feel positive about a pregnancy than were men (odds ratio, 0.3). Respondents' positive feelings about their relationships were associated with a strong tendency toward more positive feelings about a pregnancy (2.1), as was a measure of how positive respondents thought their partners would feel (1.5-2.6). The latter association was particularly strong among women (1.7). CONCLUSIONS: Relationship characteristics were associated with feelings about pregnancy for both genders. Future research should utilize a more comprehensive framework for conceptualizing and examining sexual relationships.

The reproductive health behaviors of HIV-infected young women in the United States: A literature review.

HIV-infected young women in the United States have important reproductive health needs that are made more complex by their HIV status. We searched Pubmed and relevant bibliographies to identify 32 articles published from 2001 to July 2012 that described the prevalence, correlates, and characteristics of the sexual activity, relationships, pregnancy intentions, HIV status disclosure, and contraceptive and condom use among US HIV-infected adolescents and young women. Our synthesis of those articles found that, like youth not infected with HIV, substantial proportions of HIV-infected youth were sexually active, and most sought romantic or sexual relationships, though their serostatus may have affected the pace of physical and emotional intimacy. Disclosure was difficult, and large proportions of HIV-infected youth had not disclosed their serostatus to recent partners. A few studies suggest that most HIV-infected young women hoped to have children in the future, but many wanted to avoid pregnancy until later. Only one study described contraceptive use among this population in detail and found that condoms were a primary method of contraception. The results point to substantial gaps in published research, particularly in the areas of pregnancy intentions and contraceptive use. Much more needs to be done in research and health services to better understand and meet the complex health needs of HIV-infected young women.

The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

CONTEXT: Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. EVIDENCE ACQUISITION: Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. EVIDENCE SYNTHESIS: Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. CONCLUSIONS: Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education.