Childhood Adversity, Impulsivity, and HIV Knowledge as Predictors of Sexual Risk Outcomes in At-Risk Female Youth
Abstract
:1. Introduction
1.1. HIV Knowledge as a Predictor of Sexual Risk Behavior
1.2. HIV Knowledge as a Predictor of Condom Use Efficacy
1.3. Adverse Childhood Experiences (ACEs) and Sexual Risk Behavior
1.4. Impulsivity and Sexual Risk Behavior
1.5. Current Study
2. Materials and Methods
2.1. Participants
2.2. Measures
2.3. Analytic Approach
3. Results
3.1. Bivariate Associations
3.2. Regression Analysis
4. Discussion
HIV Knowledge and Condom Use Efficacy
5. Limitations
6. Implications for Prevention, Intervention, and Future Research
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Tolman, D.L.; McClelland, S.I. Normative Sexuality Development in Adolescence: A Decade in Review, 2000–2009. J. Res. Adolesc. 2011, 21, 242–255. [Google Scholar] [CrossRef]
- Centers for Disease Control and Prevention. Sexual Risk Behaviors: HIV, STD, and Teen Pregnancy Prevention. 2020. Available online: https://www.cdc.gov/healthyyouth/sexualbehaviors/ (accessed on 18 February 2021).
- Centers for Disease Control and Prevention. HIV and Youth. 2018. Available online: https://www.cdc.gov/hiv/group/age/youth/index.html (accessed on 18 February 2021).
- Higgins, J.A.; Hoffman, S.; Dworkin, S.L. Rethinking gender, heterosexual men, and women’s vulnerability to HIV/AIDS. Am. J. Public Health 2010, 100, 435–445. [Google Scholar] [CrossRef] [PubMed]
- Yi, T.J.; Shannon, B.; Prodger, J.; McKinnon, L.; Kaul, R. Genital immunology and HIV susceptibility in young women. Am. J. Reprod. Immunol. 2012, 69, 74–79. [Google Scholar] [CrossRef] [PubMed]
- Li, Y.; Marshall, C.M.; Rees, H.C.; Nunez, A.; Ezeanolue, E.E.; Ehiri, J.E. Intimate partner violence and HIV infection among women: A systematic review and meta-analysis. J. Int. AIDS Soc. 2014, 17, 18845. [Google Scholar] [CrossRef]
- Morrison-Beedy, D.; Xia, Y.; Passmore, D. Sexual risk factors for partner age discordance in adolescent girls and their male partners. J. Clin. Nurs. 2013, 22, 3289–3299. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Centers for Disease Control and Prevention. Reported STDs in the United States. 2018. Available online: https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/std-trends-508.pdf (accessed on 18 February 2021).
- Kearney, M.S.; Levine, P. Explaining Recent Trends in the U.S. Teen Birth Rate; National Bureau of Economic Research: Massachusetts, UK, 2012. [Google Scholar]
- Copenhaver, M.M.; Johnson, B.T.; Lee, I.-C.; Harman, J.J.; Carey, M.P.; SHARP Research Team. Behavioral HIV risk reduction among people who inject drugs: Meta-analytic evidence of efficacy. J. Subst. Abus. Treat. 2006, 31, 163–171. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Protogerou, C.; Johnson, B.T. Factors Underlying the Success of Behavioral HIV-Prevention Interventions for Adolescents: A Meta-Review. AIDS Behav. 2014, 18, 1847–1863. [Google Scholar] [CrossRef]
- Hahm, H.C.; Lee, Y.; Ozonoff, A.; Van Wert, M.J. The Impact of Multiple Types of Child Maltreatment on Subsequent Risk Behaviors among Women during the Transition from Adolescence to Young Adulthood. J. Youth Adolesc. 2010, 39, 528–540. [Google Scholar] [CrossRef] [Green Version]
- Hillis, S.D.; Anda, R.F.; Felitti, V.J.; Marchbanks, P.A. Adverse Childhood Experiences and Sexual Risk Behaviors in Women: A Retrospective Cohort Study. Fam. Plan. Perspect. 2001, 33, 206–211. [Google Scholar] [CrossRef]
- Wilson, H.W.; Widom, C.S. An examination of risky sexual behavior and HIV in victims of child abuse and neglect: A 30-year follow-up. Health Psychol. 2008, 27, 149–158. [Google Scholar] [CrossRef]
- Dir, A.L.; Coskunpinar, A.; Cyders, M.A. A meta-analytic review of the relationship between adolescent risky sexual behavior and impulsivity across gender, age, and race. Clin. Psychol. Rev. 2014, 34, 551–562. [Google Scholar] [CrossRef] [PubMed]
- Hughes, A.K.; Admiraal, K.R. A Systematic Review of HIV/AIDS Knowledge Measures. Res. Soc. Work Pract. 2011, 22, 313–322. [Google Scholar] [CrossRef]
- Widman, L.; Evans, R.; Javidi, H.; Choukas-Bradley, S. Assessment of Parent-Based Interventions for Adolescent Sexual Health: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2019, 173, 866–877. [Google Scholar] [CrossRef] [PubMed]
- Carey, M.P.; Morrison-Beedy, D.; Johnson, B.T. The HIV-Knowledge Questionnaire: Development and Evaluation of a Reliable, Valid, and Practical Self-Administered Questionnaire. AIDS Behav. 1997, 1, 61–74. [Google Scholar] [CrossRef]
- Carey, M.P.; Schroder, K.E.E. Development and Psychometric Evaluation of the Brief HIV Knowledge Questionnaire (HIV-KQ-18). AIDS Educ. Prev. 2002, 14, 172–182. [Google Scholar] [CrossRef]
- Morrison-Beedy, D.; Carey, M.P.; Feng, C.; Tu, X.M. Predicting sexual risk behaviors among adolescent and young women using a prospective diary method. Res. Nurs. Health 2008, 31, 329–340. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Swenson, R.R.; Rizzo, C.J.; Brown, L.K.; Vanable, P.A.; Carey, M.P.; Valois, R.F.; DiClemente, R.J.; Romer, D. HIV Knowledge and Its Contribution to Sexual Health Behaviors of Low-Income African American Adolescents. J. Natl. Med. Assoc. 2010, 102, 1173–1182. [Google Scholar] [CrossRef] [Green Version]
- Baele, J.; Dusseldorp, E.; Maes, S. Condom use self-efficacy: Effect on intended and actual condom use in adolescents. J. Adolesc. Health 2001, 28, 421–431. [Google Scholar] [CrossRef]
- Casey, M.K.; Timmermann, L.; Allen, M.; Krahn, S.; Turkiewicz, K.L. Response and Self-Efficacy of Condom Use: A Meta-Analysis of this Important Element of AIDS Education and Prevention. South. Commun. J. 2009, 74, 57–78. [Google Scholar] [CrossRef]
- O’Leary, A.; Jemmott, L.S.; Jemmott, J.B. Mediation analysis of an effective sexual risk-reduction intervention for women: The importance of self-efficacy. Health Psychol. 2008, 27 (Suppl. 2), S180–S184. [Google Scholar] [CrossRef]
- French, S.E.; Holland, K.J. Condom negotiation strategies as a mediator of the relationship between self-efficacy and condom use. J. Sex Res. 2013, 50, 48–59. [Google Scholar] [CrossRef] [PubMed]
- Kann, L.; McManus, T.; Harris, W.A.; Shanklin, S.L.; Flint, K.H.; Queen, B.; Lowry, R.; Chyen, D.; Whittle, L.; Thornton, J.; et al. Youth Risk Behavior Surveillance—United States, 2017. MMWR Surveill. Summ. 2018, 67, 1–114. [Google Scholar] [CrossRef] [PubMed]
- Teitelman, A.M.; Ratcliffe, S.J.; Dichter, M.E.; Sullivan, C.M. Recent and Past Intimate Partner Abuse and HIV Risk among Young Women. J. Obstet. Gynecol. Neonatal Nurs. 2008, 37, 219–227. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Teitelman, A.M.; Tennille, J.; Bohinski, J.M.; Jemmott, L.S.; Jemmott, J.B., III. Unwanted unprotected sex: Condom coercion by male partners and self-silencing of condom negotiation among adolescent girls. Adv. Nurs. Sci. 2011, 34, 243–259. [Google Scholar] [CrossRef] [PubMed]
- Bandura, A. Social cognitive theory and exercise of control over HIV infection. In Preventing AIDS; DiClemente, R.J., Peterson, J.L., Eds.; Springer: Boston, MA, USA, 1994; pp. 25–59. [Google Scholar] [CrossRef]
- Ritchwood, T.D.; Penn, D.; Peasant, C.; Albritton, T.; Corbie-Smith, G. Condom use self-efficacy among younger rural adolescents: The influence of parent-teen communication, and knowledge of and attitudes toward condoms. J. Early Adolesc. 2017, 37, 267–283. [Google Scholar] [CrossRef]
- Lindberg, C.E. Knowledge, Self-Efficacy, Coping, and Condom Use Among Urban Women. J. Assoc. Nurses AIDS Care 2000, 11, 80–90. [Google Scholar] [CrossRef]
- Felitti, V.J.; Anda, R.F.; Nordenberg, D.; Williamson, D.F.; Spitz, A.M.; Edwards, V.; Koss, M.P.; Marks, J.S. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. Am. J. Prev. Med. 1998, 14, 245–258. [Google Scholar] [CrossRef]
- Bellis, M.A.; Lowey, H.; Leckenby, N.; Hughes, K.; Harrison, D. Adverse childhood experiences: Retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population. J. Public Health 2014, 36, 81–91. [Google Scholar] [CrossRef] [Green Version]
- Abram, K.M.; Teplin, L.A.; Charles, D.R.; Longworth, S.L.; McClelland, G.M.; Dulcan, M.K. Posttraumatic Stress Disorder and Trauma in Youth in Juvenile Detention. Arch. Gen. Psychiatry 2004, 61, 403–410. [Google Scholar] [CrossRef] [Green Version]
- Baglivio, M.T.; Epps, N.; Swartz, K.; Huq, M.S.; Sheer, A.; Hardt, N.S. The prevalence of adverse childhood experiences (ACE) in the lives of juvenile offenders. J. Juv. Justice 2014, 3, 1–17. [Google Scholar]
- Dierkhising, C.B.; Ko, S.J.; Woods-Jaeger, B.; Briggs, E.C.; Lee, R.; Pynoos, R.S. Trauma histories among justice-involved youth: Findings from the National Child Traumatic Stress Network. Eur. J. Psychotraumatol. 2013, 4, 20274. [Google Scholar] [CrossRef]
- Leve, L.D.; Van Ryzin, M.J.; Chamberlain, P. Sexual Risk Behavior and STI Contraction among Young Women with Prior Juvenile Justice Involvement. J. HIV/AIDS Soc. Serv. 2015, 14, 171–187. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Colman, I.; Kingsbury, M.; Garad, Y.; Zeng, Y.; Naicker, K.; Patten, S.B.; Jones, P.B.; Wild, T.C.; Thompson, A.H. Consistency in adult reporting of adverse childhood experiences. Psychol. Med. 2015, 46, 543–549. [Google Scholar] [CrossRef] [PubMed]
- Khurana, A.; Romer, D.; Betancourt, L.M.; Brodsky, N.L.; Giannetta, J.M.; Hurt, H. Early adolescent sexual debut: The mediating role of working memory ability, sensation seeking, and impulsivity. Dev. Psychol. 2012, 48, 1416–1428. [Google Scholar] [CrossRef] [Green Version]
- Khurana, A.; Romer, D.; Betancourt, L.M.; Brodsky, N.L.; Giannetta, J.M.; Hurt, H. Stronger Working Memory Reduces Sexual Risk Taking in Adolescents, Even after Controlling for Parental Influences. Child Dev. 2015, 86, 1125–1141. [Google Scholar] [CrossRef] [PubMed]
- Stevens, L.; Verdejo-García, A.; Goudriaan, A.E.; Roeyers, H.; Dom, G.; Vanderplasschen, W. Impulsivity as a vulnerability factor for poor addiction treatment outcomes: A review of neurocognitive findings among individuals with substance use disorders. J. Subst. Abus. Treat. 2014, 47, 58–72. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Stanger, C.; Ryan, S.R.; Fu, H.; Landes, R.D.; Jones, B.A.; Bickel, W.K.; Budney, A.J. Delay discounting predicts adolescent substance abuse treatment outcome. Exp. Clin. Psychopharmacol. 2012, 20, 205–212. [Google Scholar] [CrossRef] [PubMed]
- Meinck, F.; Steinert, J. Measuring and Monitoring the Prevalence of Child Maltreatment in the Community: An Overview of Measures. 2015. Available online: https://www.researchgate.net/profile/Franziska_Meinck/publication/326261578_Overview_of_child_abuse_measures_conducted_for_a_WHO_consultancy_-_not_published/links/5b424235a6fdccbcf90da599/Overview-of-child-abuse-measures-conducted-for-a-WHO-consultancy-not-published.pdf (accessed on 18 February 2021).
- Wingenfeld, K.; Schäfer, I.; Terfehr, K.; Grabski, H.; Driessen, M.; Grabe, H.; Löwe, B.; Spitzer, C. The reliable, valid and economic assessment of early traumatization: First psychometric characteristics of the German version of the Adverse Childhood Experiences Questionnaire (ACE). Psychother. Psychosom. Med. Psychol. 2010, 61, e10–e14. [Google Scholar] [CrossRef]
- Patton, J.H.; Stanford, M.S.; Barratt, E.S. Factor structure of the Barratt impulsiveness scale. J. Clin. Psychol. 1995, 51, 768–774. [Google Scholar] [CrossRef]
- Stanford, M.S.; Mathias, C.W.; Dougherty, D.M.; Lake, S.L.; Anderson, N.E.; Patton, J.H. Fifty years of the Barratt Impulsiveness Scale: An update and review. Pers. Individ. Differ. 2009, 47, 385–395. [Google Scholar] [CrossRef]
- Capaldi, D.M.; Stoolmiller, M.; Clark, S.; Owen, L.D. Heterosexual risk behaviors in at-risk young men from early adolescence to young adulthood: Prevalence, prediction, and association with STD contraction. Dev. Psychol. 2002, 38, 394–406. [Google Scholar] [CrossRef] [PubMed]
- Kim, H.K.; Pears, K.C.; Leve, L.D.; Chamberlain, P.C.; Smith, D.K. Intervention Effects on Health-Risking Sexual Behavior Among Girls in Foster Care: The Role of Placement Disruption and Tobacco and Marijuana Use. J. Child Adolesc. Subst. Abus. 2013, 22, 370–387. [Google Scholar] [CrossRef] [Green Version]
- Hensel, D.J.; Fortenberry, J.D. A Multidimensional Model of Sexual Health and Sexual and Prevention Behavior Among Adolescent Women. J. Adolesc. Health 2013, 52, 219–227. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hoehn, E.F.; Fitzgerald, M.R.; Bhatt, S.R.; Robinson, V.M.; Lippe, J.E.; Reed, J.L. Do Adolescents with Higher Knowledge of HIV Have Lower Sexual Risk Behaviors? Pediatr. Emerg. Care 2016, 32, 846–850. [Google Scholar] [CrossRef] [PubMed]
- Johnston, C.; Marshall, B.; Qi, J.; Zonneveld, C.; Kerr, T.; Montaner, J.; Wood, E. HIV knowledge and perceptions of risk in a young, urban, drug-using population. Public Health 2011, 125, 791–794. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Raiford, J.L.; Seth, P.; DiClemente, R.J. What Girls Won’t Do for Love: Human Immunodeficiency Virus/Sexually Transmitted Infections Risk Among Young African-American Women Driven by a Relationship Imperative. J. Adolesc. Health 2013, 52, 566–571. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wingood, G.M.; DiClemente, R.J. Application of the Theory of Gender and Power to Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women. Health Educ. Behav. 2000, 27, 539–565. [Google Scholar] [CrossRef]
- Minton, H.A.M.; Mittal, M.; Elder, H.; Carey, M.P. Relationship Factors and Condom Use Among Women with a History of Intimate Partner Violence. AIDS Behav. 2015, 20, 225–234. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mittal, M.; Senn, T.E.; Carey, M.P. Intimate Partner Violence and Condom Use Among Women: Does the Information–Motivation–Behavioral Skills Model Explain Sexual Risk Behavior? AIDS Behav. 2012, 16, 1011–1019. [Google Scholar] [CrossRef] [Green Version]
- Shorey, R.C.; Fite, P.J.; Choi, H.J.; Cohen, J.R.; Stuart, G.L.; Temple, J.R. Dating Violence and Substance Use as Longitudinal Predictors of Adolescents’ Risky Sexual Behavior. Prev. Sci. 2015, 16, 853–861. [Google Scholar] [CrossRef] [Green Version]
- Albarracín, D.; Gillette, J.C.; Earl, A.N.; Glasman, L.R.; Durantini, M.R.; Ho, M.-H. A Test of Major Assumptions About Behavior Change: A Comprehensive Look at the Effects of Passive and Active HIV-Prevention Interventions Since the Beginning of the Epidemic. Psychol. Bull. 2005, 131, 856–897. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fisher, W.A.; Williams, S.S.; Fisher, J.D.; Malloy, T.E. Understanding AIDS Risk Behavior among Sexually Active Urban Adolescents: An Empirical Test of the Information–Motivation–Behavioral Skills Model. AIDS Behav. 1999, 3, 13–23. [Google Scholar] [CrossRef]
- Newcomb, M.E.; Mustanski, B. Cognitive influences on sexual risk and risk appraisals in men who have sex with men. Health Psychol. 2014, 33, 690–698. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Scott-Sheldon, L.A.J.; Carey, M.P.; Vanable, P.A.; Senn, T.E.; Coury-Doniger, P.; Urban, M.A. Predicting Condom Use among STD Clinic Patients Using the Information—Motivation-Behavioral Skills (IMB) Model. J. Health Psychol. 2010, 15, 1093–1102. [Google Scholar] [CrossRef] [PubMed]
- Huebner, D.M.; Perry, N.S. Do Behavioral Scientists Really Understand HIV-Related Sexual Risk Behavior? A Systematic Review of Longitudinal and Experimental Studies Predicting Sexual Behavior. Arch. Sex. Behav. 2015, 44, 1915–1936. [Google Scholar] [CrossRef] [PubMed]
- Curry, I.; Luk, J.W.; Trim, R.S.; Hopfer, C.J.; Hewitt, J.K.; Stallings, M.C.; Brown, S.A.; Wall, T.L. Impulsivity Dimensions and Risky Sex Behaviors in an At-Risk Young Adult Sample. Arch. Sex. Behav. 2017, 47, 529–536. [Google Scholar] [CrossRef]
- Pack, R.P.; Crosby, R.A.; Lawrence, J.S.S. Associations Between Adolescents’ Sexual Risk Behavior and Scores on Six Psychometric Scales: Impulsivity Predicts Risk. J. HIV/AIDS Prev. Educ. Adolesc. Child. 2001, 4, 33–47. [Google Scholar] [CrossRef]
- Moshier, S.J.; Ewen, M.; Otto, M.W. Impulsivity as a moderator of the intention-behavior relationship for illicit drug use in patients undergoing treatment. Addict. Behav. 2013, 38, 1651–1655. [Google Scholar] [CrossRef] [Green Version]
- Dvir, Y.; Ford, J.D.; Hill, M.; Frazier, J.A. Childhood Maltreatment, Emotional Dysregulation, and Psychiatric Comorbidities. Harv. Rev. Psychiatry 2014, 22, 149–161. [Google Scholar] [CrossRef]
- Shin, S.H.; McDonald, S.E.; Conley, D. Profiles of adverse childhood experiences and impulsivity. Child Abus. Negl. 2018, 85, 118–126. [Google Scholar] [CrossRef] [PubMed]
- Espeleta, H.C.; Brett, E.I.; Ridings, L.E.; Leavens, E.L.; Mullins, L.L. Childhood adversity and adult health-risk behaviors: Examining the roles of emotion dysregulation and urgency. Child Abus. Negl. 2018, 82, 92–101. [Google Scholar] [CrossRef] [PubMed]
- Hennessy, M.; Bleakley, A.; Fishbein, M.; Jordan, A. Validating an Index of Adolescent Sexual Behavior Using Psychosocial Theory and Social Trait Correlates. AIDS Behav. 2008, 12, 321–331. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Variable Name | 1 | 2 | 3 | 4 | 5 | 6 | |
---|---|---|---|---|---|---|---|
1 | Age (in years) | − | |||||
2 | Impulsivity (BIS-11) | −0.06 | − | ||||
3 | ACE score | 0.10 | 0.14 | − | |||
4 | HIV-K | 0.30 *** | −0.21 * | −0.003 | − | ||
5 | Sexual risk | 0.52 *** | 0.16 † | 0.31 *** | 0.24 ** | − | |
6 | Condom use efficacy a | 0.02 | 0.11 | −0.02 | 0.34 * | −0.27 † | − |
Mean (SD); Range | 15.40 (1.48); 13.02–18.09 | 57.55 (8.23); 35–88 | 3.08 (2.33); 0–10 | 0.69 (0.16); 0.25–1.00 | 0.01 (0.73); −0.81–2.10 | 3.18 (0.58); 1.5–4.0 |
Outcome Variables | ||
---|---|---|
Sexual Risk (n = 121) | Condom Use Efficacy (n = 67) | |
Predictor Variable | ||
HIV Knowledge | 0.65 (0.33), p = 0.05 | 1.68 (0.42), p < 0.001 |
Covariates | ||
Age (in years) | 0.23 (0.04), p < 0.001 | −0.01 (0.05), p = 0.80 |
Impulsivity (BIS-11) | 0.02 (0.01), p < 0.05 | 0.02 (0.01), p < 0.05 |
ACE score | 0.07 (0.03), p < 0.01 | −0.02 (0.03), p = 0.57 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kovensky, R.; Khurana, A.; Guyer, S.; Leve, L.D. Childhood Adversity, Impulsivity, and HIV Knowledge as Predictors of Sexual Risk Outcomes in At-Risk Female Youth. Adolescents 2021, 1, 56-69. https://0-doi-org.brum.beds.ac.uk/10.3390/adolescents1010006
Kovensky R, Khurana A, Guyer S, Leve LD. Childhood Adversity, Impulsivity, and HIV Knowledge as Predictors of Sexual Risk Outcomes in At-Risk Female Youth. Adolescents. 2021; 1(1):56-69. https://0-doi-org.brum.beds.ac.uk/10.3390/adolescents1010006
Chicago/Turabian StyleKovensky, Rachel, Atika Khurana, Sally Guyer, and Leslie D. Leve. 2021. "Childhood Adversity, Impulsivity, and HIV Knowledge as Predictors of Sexual Risk Outcomes in At-Risk Female Youth" Adolescents 1, no. 1: 56-69. https://0-doi-org.brum.beds.ac.uk/10.3390/adolescents1010006