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.

项目概要 青少年是指 10 至 19 岁之间的年轻人，极易感染艾滋病毒和其他疾病 在艾滋病毒治疗过程中，性传播疾病比成人更有可能出现不良结果。虽然有 虽然艾滋病毒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 为性活跃青少年提供易于使用且具有成本效益的艾滋病毒和性病预防工具。此外，避孕套 是唯一既能减少艾滋病毒/性病传播又能预防意外感染的预防方法 怀孕。然而，美国数据显示，只有 54% 的性活跃青少年在上次性行为时使用了安全套， 世界许多其他地区的利率也同样较低。至关重要的是我们要了解影响因素 最强烈地预测安全套的使用，以便他们有针对性地增加青少年安全套的使用。 该 R03 项目的目的是对有关青少年性健康的文献进行荟萃分析，以确定 当代青少年使用安全套的最强社会心理预测因素。虽然类似的荟萃分析 Sheeran 及其同事于 1999 年进行的一项研究中，121 项研究中只有 30 项重点关注 青少年时期，该研究仅限于异性恋个体，目前结果已超过20岁。 青春期是一个独特的发展时期，青少年正在经历快速的神经生物学、身体、 情绪和性方面的变化，并开始协商浪漫和性关系。因此，因素 最能预测成人使用安全套的数据可能与预测成人使用安全套的数据不同。 青少年。此外，在过去的二十年里，社会文化发生了巨大的变化，技术也取得了进步。 改变了青少年的性景观。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）使用安全套的最强心理社会预测因素。 我们将重点关注艾滋病风险三个基于理论的阶段中组织的 50 个心理社会变量 还原模型：标签阶段（例如HIV/STD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、使用安全套的目的、伴侣态度、自我 功效）;和实施阶段（安全套的可用性、伴侣性沟通）。我们还包括几个 人口因素（例如性别、种族/民族、社会经济地位、宗教信仰）、个性特征（例如冲动、情绪化） 法规）以及可能影响青少年安全套使用的背景因素（例如 IPV、物质使用）。然后 在目标 2 中，我们将检查已确定的关系之间的几个潜在调节因素 心理社会变量和安全套的使用。具体来说，我们将检查这些关联是否因以下原因而有所不同： 人口特征（年龄、性别、种族/民族、性别认同）或方法特征 （研究设计，学习年）。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。该荟萃分析的结果可用于提供更多信息 有效的艾滋病毒、性传播疾病和怀孕预防工作，并完善青少年的健康行为理论。