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We analyzed cross-sectional data collected from a U.S. nationally representative survey of individuals ages 14–24 years old on what sources of information from the past year they considered to be the most helpful about how to have sex ( n  = 600 adolescents ages 14–17 years old, and n  = 666 young adults ages 18–24 years old). Among the 324 adolescents who indicated that they had been helped by at least one source of information, helpful information was most likely to have come from parents (31.0%) and friends (21.6%). Only 8.4% of adolescents said pornography was helpful. However, for those in the 18–24-year-old age group, pornography was the most commonly endorsed helpful source (24.5%), as compared to other possible options such as sexual partners, friends, media, and health care professionals. Multivariable regression analyses revealed that indicating that pornography was the most helpful source of information about how to have sex, compared to the other sources, was inversely associated with being female ( OR  = 0.32, p  = .001), inversely associated with identifying as bisexual compared to heterosexual ( OR  = 0.15, p  = .038), positively associated with being Black compared to being white non-Hispanic ( OR  = 4.26, p  = .021), inversely associated with reporting a household income of either $25 K to $49,999 ( OR  = 0.31, p  = .010) or $50 K to $74,999 ( OR  = 0.36, p  = .019) compared to more than $75 K, and positively associated with having masturbated ( OR  = 13.20, p  = .005). Subsequent research should investigate the role of pornography in both adolescent and adult sexual development, including why one-quarter of U.S. young adults say that pornography is a helpful source of information about how to have sex and what they think that they are learning from it.

Despite recommendations in the U.S. for routine HPV vaccination of adolescent girls since 2006, rates of vaccination continue to be low. This study reports vaccination uptake, factors associated with vaccine uptake and reasons for non-vaccination within a national sample of adolescent females during 2010. Using a computer administered survey of a national sample of 501 mothers of daughters 14–17 years old we assessed maternal reports of HPV vaccination as well as socio-demographical factors, maternal HPV exposures and reasons chosen for non-vaccination. Reported HPV vaccination rates were slightly over 50 % (51.1 %), with 38.3 % reporting completion of all 3 doses. Socioeconomic and demographic factors were not associated with vaccination initiation; however, Blacks and Hispanics were less likely to complete vaccination. The most common reasons for non-vaccination were concerns about vaccine safety, danger to daughter, and provider non-recommendation. Relatively poor HPV vaccine initiation and only modest 3-dose completion continues to be a major public health concern that requires continued efforts to address identified predictors and reasons for non-vaccination.

Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18–25) wherein 44.5% ( n  = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.

Compared to studies on sexually transmitted infections and pregnancy prevention, sexual pleasure has received limited attention in the adolescent sexual development literature. In the present study, we used data from 157 adolescents (66 females; 14 to 17 years old), with a partnered sexual experience in the past 12 months to explore adolescents’ sexual pleasure. First, we examined adolescents’ perceptions of pleasure during their most recent partnered sexual experience. We then used information about those sexual experiences to identify correlates of sexual pleasure. Adolescents’ reports of sexual pleasure were mixed. Although 17.8% reported their sexual experience was extremely pleasurable and 36.5% reported it was quite pleasurable, 26.6% indicated moderate pleasure, 13.1% a little pleasure, and 3.3% reported no pleasure. Sexual pleasure was primarily associated with aspects of sexual experiences that reflected socioemotional intimacy and desire. Specifically, cuddling with partners, emotional intimacy, and wantedness were all associated with greater sexual pleasure. Additionally, adolescents found sex more pleasurable when it occurred with a friend, but less pleasurable when it involved genital rubbing. Most sexual behaviors, having experienced orgasm, and the situational context of sexual experiences were not associated with sexual pleasure. Thus, specific sexual behaviors and orgasm may have less impact on sexual pleasure than feelings of emotional intimacy and desire. The diversity of perceived sexual pleasure and its associations with intimacy and desire suggest that, during adolescence, partnered sexual experiences are not primarily motivated by anticipated physical pleasure.

PrEP adoption among African-American men-who-have-sex-with-men (AAMSM) remains low. We applied Diffusion-of-Innovations (DOI) theory to understand PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM; N = 181; 17–24 years). Quantitative and qualitative analyses were used to examine predictors of PrEP diffusion stages. Most AAYMSM were in the persuasion stage (PrEP-aware, hadn’t adopted; 72.4%). Our results suggest that model antecedents are DOI stage-specific. PrEP awareness (knowledge stage) was associated with lower levels of social stigma (p < .03) and greater health literacy (p < .05), while sexual risk (p < .03) and education (p < .03) predicted PrEP adoption (12.2%). PrEP efficacy and side effects were primary innovation characteristics influencing adoption receptivity in the persuasion stage. Interventions to improve PrEP diffusion should be tailored to stage-specific antecedents depending on how a community is stratified across the DOI stages.

BackgroundIndividuals with mental illness and co-occurring substance use disorders often rapidly cycle through the justice system with multiple arrests. Therefore, is it imperative to examine the prevalence of mental health and substance use diagnoses among arrestees and repeat arrestees to identify opportunities for intervention.MethodsWe linked police arrest and clinical care data at the individual level to conduct a retrospective cohort study of all individuals arrested in 2016 in Indianapolis, Indiana. We classified arrestees into three levels: 1 arrest, 2 arrests, or 3 or more arrests. We included data on clinical diagnoses between January 1, 2014 and December 31, 2015 and classified mental health diagnoses and substance use disorder (SUD) based on DSM categories using ICD9/10 diagnoses codes.ResultsOf those arrested in 2016, 18,236 (79.5%) were arrested once, 3167 (13.8%) were arrested twice, and 1536 (6.7%) were arrested three or more times. In the 2 years before the arrest, nearly one-third (31.3%) of arrestees had a mental health diagnosis, and over a quarter (27.7%) of arrestees had an SUD diagnosis. Most of those with a mental health or SUD diagnosis had both (22.5% of all arrestees). Arrestees with multiple mental health (OR 2.68, 95% CI 2.23, 3.23), SUD diagnoses (OR 1.59, 95% CI 1.38, 1,82), or co-occurring conditions (1.72, 95% CI 1.48, 2.01) in the preceding 2 years had higher odds of repeat arrest.ConclusionsOur findings show that linked clinical and criminal justice data systems identify individuals at risk of repeat arrest and inform opportunities for interventions aimed at low-level offenders with behavioral health needs.

BackgroundHomicide is a widely acknowledged public health problem in the United States. The majority of homicides are committed with a firearm and have long-term health consequences for family members and entire communities. When left unsolved, violence may be perpetuated due to the retaliatory nature of homicides. Improving homicide clearance rates may help prevent future violence, however, we know little about the community-level social dynamics associated with unsolved homicides.MethodsThis study examines the individual-and-community-level social processes associated with low homicide clearance rates in Indianapolis, Indiana between 2007 and 2017. Homicide clearance is the primary outcome, defined as if a perpetrator was arrested for that homicide case between 2007 and 2017. Individual-level variables include the victim’s race/ethnicity, sex, and age. Community-level (i.e., census tracts) variables include the number of resident complaints against the police, resident complains of community disorder, income inequality, number of police interactions, and proportion of African American residents.ResultsIn Indianapolis over a 11-year period, the homicide clearance rate decreased to a low of 38% in 2017, compared to a national clearance rate of 60%. Homicide case clearance was less likely for minority (OR 0.566; 95% CI, 0.407–0.787; p < 0.01) and male (OR 0.576; 95% CI, 0.411–0.807; p < 0.01) victims. Resident complaints of community disorder were associated with a decreased odds of case clearance (OR 0.687; 95% CI, 0.485–0.973; p < .01)., African American victim’s cases were less likely to be cleared in 2014–2017 (OR 0.640; 95% CI, 0.437–0.938; p < 0.05), compared to 2007.ConclusionsOur study identified differences in neighborhood social processes associated with homicide clearance, indicating existing measures on these community factors are complex. Programs aimed at improving signs of community disorder and building community engagement may improve neighborhood clearance rates, lower violence, and improve the health of these communities.

There is a critical need to understand the interplay between relationship trust and public health outcomes. The purpose of this study was to develop an understanding of emerging adult women's processes of establishing trust in sexual relationships. Twenty-five women aged 18-24 years participated in semi-structured interviews. Throughout the interviews, women compared and contrasted experiences in which they felt comfortable engaging in sexual intercourse with a partner versus times in which they did not feel comfortable. Analysis was based on a critical qualitative research orientation. When asked to speak to instances when they felt comfortable having sex, most women spoke about relationship trust. Many participants conceptualised trust based on past experiences with bad relationships or sexual violence. Based on their previous experiences of feeling unsafe or undervalued, emotional and physical security became prioritised in relationship development. Trust was developed through friendship, communication over time, and through shared life experiences. This research is among the first to qualitatively investigate trust formation and other impersonal dynamics related to sexual health decision-making. Insights from this study should be translated into future action by public health practitioners to promote healthy sexual relationships and communication about sexual health topics as a form of trust building.

Trust is experienced almost constantly in all forms of social and interpersonal relationships, including sexual relationships, and may contribute both directly and indirectly to sexual health. The purpose of this review is to link three aspects of trust to sexual health: (1) the role of trust in sexual relationships; (2) the role of trust in sexually transmitted infection (STI) prevention, particularly condom use; and (3) the relevance of trust in sexual relationships outside of the traditional model of monogamy. The review ends with consideration of perspectives that could guide new research toward understanding the enigmas of trust in partnered sexual relations in the context of sexual and public health.

Leadership development is a core value of Maternal Child Health Bureau training programs. Mentorship, an MCH Leadership Competency, has been shown to positively affect career advancement and research productivity. Improving mentorship opportunities for junior faculty and trainees may increase pursuit of careers in areas such as adolescent health research and facilitate the development of new leaders in the field. Using a framework of Developmental Networks, a group of MCH Leadership Education in Adolescent Health training program faculty developed a pilot mentoring program offered at the Society for Adolescent Health and Medicine Annual Meeting (2011–2013). The program matched ten interdisciplinary adolescent health fellows and junior faculty with senior mentors at other institutions with expertise in the mentee’s content area of study in 2011. Participants were surveyed over 2 years. Respondents indicated they were “very satisfied” with their mentor match, and all agreed or strongly agreed that the mentoring process in the session was helpful, and that the mentoring relationships resulted in several ongoing collaborations and expanded their Developmental Networks. These results demonstrate that MCH programs can apply innovative strategies to disseminate the MCH Leadership Competencies to groups beyond MCH-funded training programs through programs at scientific meetings. Such innovations may enhance the structure of mentoring, further the development of new leaders in the field, and expand developmental networks to provide support for MCH professionals transitioning to leadership roles.