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D. Kirby

Bio: D. Kirby is an academic researcher from Centers for Disease Control and Prevention. The author has contributed to research in topics: Pregnancy & Reproductive health. The author has an hindex of 2, co-authored 2 publications receiving 94 citations.

Papers
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Journal Article
TL;DR: In this article, the authors reviewed the sexual behaviors and psychosocial factors associated with STDs and unintended pregnancy among adolescents as well as school-, community-, and clinic-based interventions designed to reduce risk behaviors and promote adolescent sexual health.
Abstract: Adolescence is a critical period in the development of sexual behaviors that may lead to acquiring sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and to unintended pregnancy. Understanding adolescent sexual behavior is essential for understanding adolescents' risk of pregnancy and STD/HIV infection and for planning and evaluating health promotion activities. This chapter reviews the sexual behaviors and psychosocial factors associated with STDs and unintended pregnancy among adolescents as well as school-, community-, and clinic-based interventions designed to reduce risk behaviors and promote adolescent sexual health.

86 citations


Cited by
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Journal ArticleDOI
14 Jul 2004-JAMA
TL;DR: In this article, the authors evaluated the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors.
Abstract: ContextAfrican American adolescent girls are at high risk for human immunodeficiency virus (HIV) infection, but interventions specifically designed for this population have not reduced HIV risk behaviors.ObjectiveTo evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors.Design, Setting, and ParticipantsRandomized controlled trial of 522 sexually experienced African American girls aged 14 to 18 years screened from December 1996 through April 1999 at 4 community health agencies. Participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing. Outcome assessments were made at 6- and 12-month follow-up.InterventionAll participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition.Main Outcome MeasuresThe primary outcome measure was consistent condom use, defined as condom use during every episode of vaginal intercourse; other outcome measures were sexual behaviors, observed condom application skills, incident STD infection, self-reported pregnancy, and mediators of HIV-preventive behaviors.ResultsRelative to the comparison condition, participants in the intervention reported using condoms more consistently in the 30 days preceding the 6-month assessment (unadjusted analysis, intervention, 75.3% vs comparison, 58.2%) and the 12-month assessment (unadjusted analysis, intervention, 73.3% vs comparison, 56.5%) and over the entire 12-month period (adjusted odds ratio, 2.01; 95% confidence interval [CI], 1.28-3.17; P = .003). Participants in the intervention reported using condoms more consistently in the 6 months preceding the 6-month assessment (unadjusted analysis, intervention, 61.3% vs comparison, 42.6%), at the 12-month assessment (unadjusted analysis, intervention, 58.1% vs comparison, 45.3%), and over the entire 12-month period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.50; P<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy.ConclusionInterventions for African American adolescent girls that are gender-tailored and culturally congruent can enhance HIV-preventive behaviors, skills, and mediators and may reduce pregnancy and chlamydia infection.

452 citations

Journal ArticleDOI
TL;DR: The notion that mothers who communicate with their daughters about sex can affect their daughters' sexual behaviors in positive ways support the design and implementation of family-based approaches to improve parent-adolescent sexual risk communication as one means of reducing HIV-related sexual risk behaviors among inner-city adolescent females.

422 citations

Journal ArticleDOI
TL;DR: It is suggested that psychological distress is predictive over a 6-month period of a spectrum of STD/HIV-associated sexual behaviors and high-risk attitudes and should be considered as one potential risk factor that may impact program efficacy.
Abstract: . Objective. The purpose of the study was to examine the association between adolescents’ psychological distress and their sexually transmitted disease/ human immunodeficiency virus (STD/HIV)-associated sexual behaviors and attitudes. Method. Sexually active black adolescent females (N 522) completed, at baseline and again 6 months later, a self-administered questionnaire that assessed sexual health attitudes and emotional distress symptoms (using standardized measures, .84), a structured interview that assessed STD/HIV-associated sexual risk behaviors, and a urine screen for pregnancy. Results. In multivariate analyses, controlling for observed covariates, adolescents with significant distress at baseline were more likely than their peers, after 6 months, to be pregnant (adjusted odds ratio [AOR]: 2.0), have had unprotected vaginal sex (AOR 2.1), have nonmonogamous sex partners (AOR 1.7), and not use any form of contraception (AOR 1.5). Additionally, they were also more likely to: perceive barriers to condom use (AOR 2.2), be fearful of the adverse consequences of negotiating condom use (AOR 2.0), perceive less control in their relationship (AOR 2.0), have experienced dating violence (AOR 2.4), feel less efficacious in negotiating condom use with a new sex partner (AOR 1.6), and have norms nonsupportive of a healthy sexual relationship (AOR 1.7). Discussion. The findings suggest that psychological distress is predictive over a 6-month period of a spectrum of STD/HIV-associated sexual behaviors and high-risk attitudes. Brief screening to detect distress or depressive symptoms among adolescent females can alert the clinician to the need to conduct a sexual health history, initiate STD/HIV-preventive counseling, and refer for comprehensive psychological assessment and appropriate treatment. Among adolescents receiving STD treatment,those with even moderate emotional distress may be at heightened risk for further unhealthy outcomes. STD/ HIV interventions should also consider psychological distress as one potential risk factor that may impact program efficacy.

249 citations

Journal ArticleDOI
TL;DR: In this paper, the influence of sexual communication with mothers and fathers on the sexual risk behaviors of adolescent daughters was examined and found that although mothers have consistently been found to be the primary sexual communicators with children particularly daughters fathers may play an important role through the discussion of sociosexual issues with daughters.
Abstract: In response to high rates of sexual risk behaviors and negative outcomes among adolescents delaying the initiation of sexual intercourse and increasing condom use among adolescents are identified as two public health priorities in Healthy People 2000. Recent studies have challenged popular beliefs that parents have no influence over the sexual behavior of the adolescent children. Several well-designed studies found parents’ sexual values and sexual communication with their children exert significant influences on adolescents’ attitudes toward sexuality their initiation and participation in sexual activity and their use of contraceptives and condoms. Although mothers have consistently been found to be the primary sexual communicators with children particularly daughters fathers may play an important role through the discussion of sociosexual issues with daughters. Fathers may be able to provide daughters with unique perspectives enhance their overall understanding of men and provide opportunities to role-play communication strategies with men. However much of the recent research on parent-adolescent sexual communication and family influences of adolescent sexual risk behaviors has been limited to communication and relationships with mothers. The purpose of the present study was to examine the influence of sexual communication with mothers and fathers on the sexual risk behaviors of adolescent daughters. (excerpt)

238 citations

Journal ArticleDOI
TL;DR: Psychosocial factors, particularly norms about having sex, influence initiation of sexual intercourse among middle-school, inner-city youth, and data suggest that programs to delay initiation ofSexual intercourse should reinforce norms about refraining from sex.

227 citations