The impact of a culturally appropriate STD/AIDS education intervention on black male adolescents' sexual and condom use behavior.

A culturally appropriate, theoretically based videotape was developed to promote condom use among African American males, ages 15 to 19, attending a municipal sexually transmitted disease (STD) clinic. The videotape's impacts were compared to those achieved by an African American health educator who delivered the same messages during a face-to-face session and by standard care. Data were obtained on participants' (N = 562) condom use knowledge, self-efficacy, and intentions; sexual and condom use behaviors; and perceived risk of infection. At posttest, "videotape" and "health educator" participants demonstrated greater condom use knowledge; "health educator" participants indicated greater self-efficacy and stronger condom use intentions with steady partners. At 6 months, participants in all conditions reported more partners and acts of vaginal intercourse (past month); however, they were more likely to report consistent condom use with steady partners (18% vs. 53%) and casual partners (26% vs. 50%). Perceived risk of infection was lower at the posttest and declined during the study period.

Subsequent infection among adolescent African-American males attending a sexually transmitted disease clinic.

PURPOSE: To identify predictors of subsequent infection among a sample of 15- to 19-year-old African-American males attending an urban sexually transmitted disease (STD) clinic in the Midwest. METHODS: During a 14-month period, 562 youth participated in a brief STD prevention intervention designed to promote condom use. They completed self-administered questionnaires (baseline, posttest, 30-day and 6-month) on their sexual and condom use behavior in the past month. Infection data (baseline, 5 years before, and 12 months after baseline) were obtained from clinic and state surveillance records. Logistic regression was used to predict infection within 6 and 12 months of the baseline visit. RESULTS: Within 12 months of the baseline, 31.3% were treated for an infection, of whom 1.4% returned within 30 days, an additional 17.1% within 6 months, and the remaining 12.8% within the last 6 months. The 12-month rate was 1.6-1.7 times higher than the rates reported for older STD clinic attendees. Subsequent infection was positively associated with age at first intercourse, number of children fathered, infection prior to and at the index visit, exchange of sex for drugs in the past year, and perceived risk of infection within the year; it was negatively associated with frequency of condom use with one's steady partner. CONCLUSIONS: Sexually transmitted disease clinic staff routinely obtain information from young African-American males that can be used to identify individuals who are most likely to become reinfected. Because repeaters account for a disproportionate number of infections, prevention efforts tailored to their needs would have a corresponding impact on STD rates.

Sexuality during pregnancy and the year postpartum.

BACKGROUND: There have been a few studies conducted on couples' sexual behavior during pregnancy and the year postpartum, but those studies contain sampling bias resulting from recruiting volunteers for sex research. The sample for the current research was recruited for a far less sensitive study, and includes data from both mothers and fathers. METHODS: A total of 570 pregnant women and 550 of their husbands or partners were recruited and were interviewed on four occasions: (1) at the fifth month of pregnancy (T1); (2) at 1 month postpartum (T2); (3) at 4 months postpartum (T3); and (4) at 12 months postpartum (T4). RESULTS: Although approximately 90% of couples engaged in sexual intercourse at T1, T3, and T4, only approximately 19% did at T2. On average, couples resumed intercourse at 7 weeks postpartum. At T2 and T3, women who were breastfeeding showed significantly less sexual activity and less sexual satisfaction than women who were not. There were few differences between women who gave birth vaginally and those who were delivered by cesarean section, except that the latter resumed intercourse somewhat earlier. CONCLUSIONS: Practitioners providing family-centered maternity care need to counsel couples about typical patterns of sexuality during pregnancy and postpartum, and about usual patterns during breastfeeding. Accurate information can help couples feel more comfortable during the transition periods before and after childbirth. A discussion of expected changes in sexuality should be routinely introduced by the physician during prenatal care.