Predictors of Condom Use among Adolescents: A Meta-Analysis

青少年使用安全套的预测因素：荟萃分析

• 批准号: 10451218
• 负责人: Laura M. Widman
• 金额: $ 7.6万
• 依托单位: NORTH CAROLINA STATE UNIVERSITY RALEIGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-06 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10451218
• 关键词: 20 year old; AIDS prevention; Acquired Immunodeficiency Syndrome; Adolescence; Adolescent; Adult; Affect; Age; Attitude; Characteristics; Child Rearing; Coitus; Communication; Consensus; Continuity of Patient Care; Data; Decision Making; Demographic Factors; Development; Elderly; Emotional; Ethnic Origin; Future; Gender; HIV; HIV/STD; Health behavior; Healthcare; Heterosexuals; High School Student; Impulsivity; Individual; Infection; Intervention; Knowledge; Label; Learning; Literature; Mediation; Medical; Meta-Analysis; Methodology; Methods; Modeling; Neurobiology; Outcome; Personality Traits; Persons; Policies; Population; Predictive Factor; Prevention; Prevention Measures; Prevention program; Prevention strategy; Procedures; Process; Psychosocial Factor; Publishing; Race; Research; Research Design; Review Literature; Rewards; Risk; Risk Reduction; STI prevention; Sampling; Science; Self Efficacy; Sex Education; Sexting; Sexual Health; Sexual Partners; Subgroup; Technology; Time; Unsafe Sex; Youth; adolescent sexual health; analytical method; base; condoms; contextual factors; cost effective; design; emotion regulation; high risk; interest; peer influence; pre-exposure prophylaxis; pregnancy prevention; prevent; programs; psychosocial; sex; sexual identity; sexual minority youth; sexual relationship; sexually active; sexually active adolescent; social culture; substance use; systematic review; theories; tool; transmission process; treatment as prevention; treatment strategy; unintended pregnancy

PROJECT SUMMARY Adolescents, defined as young people between the ages of 10 to 19, are highly vulnerable to HIV and other STDs and also more likely than adults to have poor outcomes along the HIV care continuum. Although there have been substantial advances in HIV prevention and treatment strategies, condoms remain the most accessible and cost-effective HIV and STD prevention tool for sexually active adolescents. Further, condoms are the only prevention method that can both reduce the transmission of HIV/STDs and prevent unintended pregnancy. Yet, U.S. data show only 54% of sexually active adolescents used a condom at last intercourse, and rates are similarly low in many other parts of the world. It is critical that we understand the factors that most strongly predict condom use so that they may be targeted to increase condom use among adolescents. The purpose of this R03 project is to meta-analyze the literature on adolescent sexual health to identify the strongest psychosocial predictors of condom use among contemporary youth. While a similar meta-analysis was conducted by Sheeran and colleagues in 1999, only 30 of 121 studies in this study focused on adolescents, the study was limited to heterosexual individuals, and results are now over 20 years old. Adolescence is a unique developmental period, whereby youth are undergoing rapid neurobiological, physical, emotional, and sexual changes and beginning to negotiate romantic and sexual relationships. Thus, the factors that are most predictive of condom use for adults may not be the same as those that predict condom use for adolescents. Further, in the past two decades, sizeable sociocultural changes and technological advances have shifted the sexual landscape for adolescents. In Aim 1, we will perform an up-to-date meta-analysis to identify the strongest psychosocial predictors of condom use among adolescents (mean age < 19). We will focus on 50 psychosocial variables organized within the three theory-based stages of the AIDS Risk Reduction Model: labeling stage (e.g., HIV/STD knowledge, threat appraisal, sex education); commitment stage (e.g., use of other biomedical HIV prevention measures, purpose of condom use, partner attitudes, self- efficacy); and enactment stage (condom availability, partner sexual communication). We also include several demographic factors (e.g., gender, race/ethnicity, SES, religiosity), personality traits (e.g., impulsivity, emotion- regulation), and contextual factors (e.g., IPV, substance use) that may affect adolescents’ condom use. Then in Aim 2, we will examine several potential moderators of the relationship between the identified psychosocial variables and condom use. Specifically, we will examine if the associations differ based on demographic characteristics (age, gender, race/ethnicity, sexual identity) or methodological characteristics (research design, study year). In addition, we will assess study quality and risk of bias to highlight the biases, strengths, and weaknesses of the existing literature. Results of this meta-analysis can be used to inform more effective HIV, STD, and pregnancy prevention efforts and refine health behavior theory among youth.

项目摘要 青少年被定义为10至19岁的年轻人，他们非常容易感染艾滋病毒和其他疾病。 性传播疾病，也比成年人更有可能有不良后果沿着艾滋病毒护理连续。虽然 尽管艾滋病预防和治疗策略取得了实质性进展，但安全套仍然是最重要的 为性行为活跃的青少年提供方便和具有成本效益的艾滋病毒和性传播疾病预防工具。此外，避孕套 是唯一既能减少艾滋病毒/性病传播，又能防止意外感染的预防方法。 怀孕然而，美国的数据显示，只有54%的性活跃青少年在最近一次性交时使用了避孕套， 在世界其他许多地方，这一比率也同样很低。我们必须了解 最强烈的预测避孕套的使用，使他们可以有针对性地增加避孕套使用的青少年。 这个R 03项目的目的是对青少年性健康的文献进行荟萃分析，以确定 当代青年使用避孕套的最强心理社会预测因素。一项类似的荟萃分析 1999年，Shepherd和他的同事进行了一项研究，在这项研究中，121项研究中只有30项集中在 青少年，这项研究仅限于异性恋者，结果现在已经超过20年了。 青春期是一个独特的发展时期，青年在此期间经历快速的神经生物学，身体， 情感和性的变化，并开始谈判浪漫和性关系。因此， 最能预测成年人使用避孕套的指标可能与预测成年人使用避孕套的指标不同。 青少年。此外，在过去二十年中，社会文化的巨大变化和技术进步 改变了青少年的性生活在目标1中，我们将进行最新的荟萃分析 确定青少年（平均年龄< 19岁）安全套使用的最强社会心理预测因素。 我们将集中在50个心理社会变量内组织的三个理论为基础的艾滋病风险的阶段 简化模型：标记阶段（例如，艾滋病毒/性病知识、威胁评估、性教育）;承诺 阶段（例如，使用其他生物医学艾滋病毒预防措施，使用避孕套的目的，伴侣的态度，自我， 有效性）;和颁布阶段（避孕套的供应，伙伴性交流）。我们还包括几个 人口因素（例如，性别、种族/民族、SES、宗教信仰），人格特质（例如，冲动情绪 监管），以及背景因素（例如，IPV，物质使用），可能会影响青少年的安全套使用。然后 在目标2中，我们将研究几个潜在的调节因素， 心理社会变量和安全套使用。具体来说，我们将检查关联是否基于 人口统计学特征（年龄、性别、人种/种族、性别认同）或方法学特征 （研究设计，研究年份）。此外，我们将评估研究质量和偏倚风险，以突出偏倚， 现有文献的优点和缺点。本荟萃分析的结果可用于提供更多信息， 有效艾滋病毒、性传播疾病和怀孕预防工作，并完善青年人的健康行为理论。