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Metrics details. To describe sexual risk behavior, alcohol and other substance use, and perceived Guthrie african mature wanting sex promotion needs among young adult women seeking care from an urban reproductive health care clinic in the Northeastern United States, and to examine if these needs differ by race and ethnicity. Women reported moderate-to-strong interest in receiving information about relationships and sexual health; however, the majority were not interested in information about their substance use.
Hispanic and African-American women were more likely to report STI history despite reporting fewer sexual partners than non-Hispanic White women. Minority women also reported ificantly less alcohol and cigarette use, but more water pipe tobacco use, and reported ificantly greater interest in interventions to promote sexual health. Reproductive health centers are opportune settings to address a broad range of healthcare needs, including sexual health, substance use, and mental health.
Young women, particularly racial and ethnic minority women, report the most interest in services addressing sexual and relationship health. Peer Review reports. Young women, particularly racial and ethnic minority women, are particularly vulnerable to sexually transmitted infections STIsing for a disproportionate percentage of all newly acquired STIs in the United States [ 1 ].
Young women evince the highest incidence of chlamydia, gonorrhea, Guthrie african mature wanting sex human papillomavirus HPV infection [ 1 ]; and one-quarter of all 20 to year-old women acquire HPV annually [ 2 ]. Young women are also uniquely at risk for unintended pregnancy [ 4 ] and sexual assault [ 5 ]. Consequently, sexual and reproductive health care is especially important for this age group and for particular subgroups of women.
Perhaps because of their unique sexual health vulnerability, young women often consider their gynecologist to be their primary care provider and their most trusted medical professional [ 6 ]. Among women in the U. This may be especially important for minority women, as Hispanic and African-American adults have low rates of mental health service utilization despite equivalent or higher rates of mental health concerns [ 10 ]. Two important correlates of risky sexual behavior are alcohol use and depressive symptoms.
For many young women, alcohol use often co-occurs with sexual behavior; research has documented alcohol use as an important correlate of sexual initiation, unprotected sex, and risky sexual behavior [ 11 ]. One in five sexually active high school females reported using alcohol during their last sexual encounter [ 13 ], and heavy drinking in particular is associated with having sexual intercourse [ 14 ].
Therefore, it Guthrie african mature wanting sex important to understand how substance use and sexual risk align among a diverse group of women. Similarly, rates Guthrie african mature wanting sex depressive symptoms are increasing among young women [ 17 ]. Further, it is important to note that although Hispanic, Non-Hispanic White, and Non-Hispanic Black women experience similar rates of depression [ 20 ], African-American and Hispanic adults are less likely to receive any treatment for depression [ 21 ].
In summary, young women are a at elevated risk for STIs and unintended pregnancies, b often use alcohol before sex, c evince concerning increases in depressive symptoms, d rely on reproductive health centers for their healthcare needs, and e benefit from integrated health services.
Despite these facts, screening for substance use and misuse in reproductive health care settings remains uncommon. Moreover, given racial and ethnic disparities in health e. Although the overarching purpose of this study was exploratory to establish the needs of young women presenting for care, we hypothesized that Hispanic and African-American women would have higher rates of STIs and be less likely to engage in alcohol misuse compared to White women, given population-level disparities.
The Institutional Review Board approved all procedures. This research took place at an urban, community-based, reproductive health care clinic located in the northeastern U. Potential participants were initially identified through medical chart reviews of patients presenting to the clinic. Of the eligible patients, 29 women were discharged from medical care before they could be approached, 16 could not be approached in private e.
Race and ethnicity were assessed separately. One item ascertained relationship status single, not in a relationship; partnered but unmarried; married; divorced; widowed; otherwhich was recoded to reflect whether participants were currently single or in a relationship. of male sex partners consisted of an open response field.
Given the non-normal distribution of the peak daily alcohol use variable, and in order to better reflect risk, this variable was used to create two variables reflecting heavy use: binge drinking i. We assessed depressive symptoms using The Patient Health Guthrie african mature wanting sex PHQ [ 25 ]a well-validated measure deed to assess depressive symptoms in a medical setting. Kroenke et al. Women indicated their interest in receiving information about seven health concerns i.
Linear regression examined continuous outcomes i. In order to understand the intersection of substance use, particularly alcohol and marijuana use, and sexual risk behaviors, we also examined lifetime STIs and of sex partners ing for substance use variables. All regression analyses controlled for age. The regression analyses for condom use controlled for relationship status as partner type is associated with condom use [ 26 ]. Outliers i. Hispanic individuals in the U. There were too few women in other racial identity to create meaningful contrasts, and these women were excluded from further analyses.
All women reported partnered sexual activity lifetime.
Regarding any past-month tobacco use i. There were no racial or ethnic differences in interest for the other health-related topics. Reproductive health clinics often serve as the primary medical home for young women, who are at elevated risk for STIs, unintended pregnancy, and alcohol misuse.
Integrated care models can address and provide treatment for behavioral health concerns within a medical setting, improving mental health, patient satisfaction, and other outcomes [ 30 ]. We found that most women were sexually active with a single partner, used condoms infrequently, drank alcohol in a typical week, and had used marijuana. Although African-American and Hispanic women reported fewer recent and lifetime sexual partners, no differences in condom use frequency, and less alcohol use than White women, they were more likely to have had an STI, and to have had multiple STIs, in their lifetimes.
This increased risk for STIs among minority women is consistent with research [ 3 ], and confirms that targeted services continue to be needed to support this population of women specifically. According to leading practitioners [ 31 ], STI disparities among ethnic minority women are in part maintained due to poorer access to health care as well as mistrust in the medical system. Therefore, it is critical to Guthrie african mature wanting sex understand the health wishes of diverse young Guthrie african mature wanting sex.
Importantly for intervention acceptability, young adult African-American and Hispanic women expressed greater interest in information about sexual health and relationships compared to White women presenting for medical care. Further, Hispanic women were particularly vulnerable to experiencing depressive symptoms in this sample, with one-quarter reporting clinically ificant levels of depressive symptoms. Research suggests that African-American and Hispanic adults are less likely to receive any treatment for depression [ 21 ], which is concerning given the equivalent or markedly higher rates of depressive symptoms among women in this sample.
These findings highlight the importance of addressing minority mental and behavioral health within medical settings in a culturally sensitive way. The women in our sample appear to be representative of the overall population of 18—year-old young adults in the state in terms of prevalence of use [ 32 ]. Nevertheless, a sizable proportion of women evidenced problematic substance use. Regarding marijuana use, Hasin et al. This greater use might in part reflect regional differences in use, as Hasin et al. In general, increasing rates of marijuana use in the U.
Less is known about the impact of frequent marijuana use specifically among women this age; however, some research suggests that marijuana use in the context of romantic relationships increases the risk of unprotected sex [ 34 ]. Therefore, this survey highlights this as an important direction for research and, perhaps, intervention. Research has suggested that Hispanic women have the lowest smoking rates of any racial or ethnic group in the United States [ 35 ]; however, our findings did not support this finding and instead suggest it is important that providers assess for tobacco use beyond cigarette use in this population, as non-White women in this sample engaged in water pipe tobacco use at rates substantially higher than in the general population of young adults [ 36 ].
This is particularly concerning given that individuals perceive waterpipe use to be less addictive and harmful [ 37 ], and suggests that providers should include tobacco products in general when screening for tobacco use among patients. Of note, women in general reported relatively low levels of interest in all health topics, such that only coping with stress or anxiety reached the midpoint of the assessment scale, indicating slight-to-moderate interest.
Even though a large proportion of young women reported problematic substance use, there was, overall, little interest in receiving intervention services about their alcohol Guthrie african mature wanting sex other substance use. Universal screening could follow the well-established SBIRT Screening, Brief Intervention, and Referral to Treatment model, which empowers healthcare providers to identify substance use and mental health concerns and engage patients in treatment that in healthcare savings and patient benefit [ 38 ].
In addition to universal screening, the highlight other novel mechanisms for treatment delivery. These services would need to be offered in a way that respects the complex and valued role that alcohol plays in the social lives of young women and does not scare away women who do not see themselves as needing such services. Such services should also prioritize education around heavy drinking specifically. Guthrie african mature wanting sex, there are now well-developed interventions approaches e. Study strengths include our large sample, use of well-established survey items, unique focus on the role of alcohol use in the context of reproductive health care, and high participation rate.
Our survey was brief to optimize participation and local site representativenessminimize respondent burden, and obtain complete data. These participation rates are quite strong. Study limitations include its cross-sectional de, which precludes causal inferences. In addition, as with any single site study, the study location and participant characteristics may not be representative of other locations.
Thus, study participants were more likely to have obtained a high school degree or its equivalent compared to the local population. To address this limitation, it is important to consider how best to reach women of lower education levels, who often have poorer access to health care [ 39 ]. A third limitation is that use of a brief survey prevented a more comprehensive assessment of health behaviors.
Finally, we assessed Hispanic ethnicity broadly without further subgroup assessment. However, the Hispanic population is a heterogeneous, and there are ificant differences in health behaviors and needs within this population of women [ 40 ]. Moreover, this study focused on sexual activity and condom use with male partners, and so these findings do not shed light on the needs of women who have sex with women, who evidence unique risks [ 41 ]. Young women at sexual and reproductive healthcare centers report sexual risk behavior and substance use, singly and together, in ways that can increase risk for STIs, unintended pregnancy, and other adverse health outcomes.
Sexual risk behavior and substance use levels among women at these settings are often elevated compared to similar aged women in the general population. Young women, particularly non-White women, appear receptive to receiving information and services targeted to sexual and relationship health as well as to other health concerns e. Interest in substance use services is less strong, indicating the need for substance counseling services that are not stigmatizing given the high rates of substance use and misuse in this population of young adult women. The present indicate that reproductive healthcare centers provide opportune settings in which to address the often unmet behavioral health needs of young women.
Centers for Disease Control and Guthrie african mature wanting sex Accessed 28 Mar Sexually transmitted infections among US women and men: prevalence and incidence estimates, Sex Transm Dis. Article Google Scholar.
Accessed 13 Feb Declines in unintended pregnancy in the United States, — N Engl J Med. Sinozich S, Langton L. Rape and sexual assault victimization among college-age females, — US Department of Justice. Accessed 2 Mar An opportunity for obstetrician-gynecologists to affect the epidemic of cardiovascular disease in women. Obstet Gynecol. Discouraging trends in reproductive health service use among adolescent and young adult women in the USA, Hum Reprod.
Reducing HIV-risk behavior among adults receiving outpatient psychiatric treatment: from a randomized controlled trial. J Consult Clin Psychol.Guthrie african mature wanting sex
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What predicts sex partner age differences among African American youth? A longitudinal study from adolescence to young adulthood