HIV/SEXUALLY TRANSMITTED INFECTION PREVENTION MESSAGING: TARGETING ROOT CAUSES OF SEXUAL RISK BEHAVIOR

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HIV/SEXUALLY TRANSMITTED INFECTION PREVENTION MESSAGING: TARGETING ROOT CAUSES OF SEXUAL RISK BEHAVIOR

`   TABLE OF CONTENTS

Cover page

Title page

Certification        –       –       –       –       –       –       –       –       i

Dedication –       –       –       –       –       –       –       –       –       ii

Acknowledgement      –       –       –       –       –       –       –       iii

Abstract     –       –       –       –       –       –       –       –       –       v

Table of contents        –       –       –       –       –       –       –       –       vi

CHAPTER ONE: INTRODUCTION

1.1    Background of the Study     –       –       –       –       –       1

1.2    Statement of Problem  –       –       –       –       –       –       7

1.3    Purpose of the study           –       –       –       –       –       8

1.4    Objective of the Study –       –       –       –       –       –       9

1.4    Research Questions    –       –       –       –       –       –       10

1.5    Research Hypothesis   –       –       –       –       –       –       10

1.6    Significance of the Study     –       –       –       –       –       11

1.7    Scope of the study      –       –       –       –       –       –       11

1.8    Limitation of the study         –       –       –       –       –

1.9    Definition of Terms             –       –       –       –       –       12

CHAPTER TWO: REVIEW OF RELATED LITERATURE

2.1    Introduction       –       –       –       –       –       –       –       14

2.2 The Theoretical frame Work –       –       –       –       –       21

2.3 conceptual frame work

2.4 empirical review

CHAPTER THREE: RESEARCH METHODOLOGY

3.1    Introduction       –       –       –       –       –       –       –       82

3.2    Area of the study                –       –       –       –       –       –       82

3.3    Research Design        –       –       –       –       –       –       82

3.4    Sample and sampling techniques –       –       –       –       83

3.5    Population of the study               –       –       –       –       –       84

3.6    Procedure for Data Collection      –       –       –       –       85

3.7    Method of Data Analysis      –       –       –       –       –       85

CHAPTER FOUR: PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

4.1    Introduction       –       –       –       –       –       –       –       87

4.2    Presentation of Data           –       –       –       –       –       87

4.3    Data Analysis     –       –       –       –       –       –       –       88

4.4    Testing of Hypothesis          –       –       –       –       –       91

4.5    Discussion and summary of findings             –       –       94

CHAPTER FIVE:

INTRODUCTION, SUMMARY, RECOMMENDATIONS AND CONCLUSION

5.0    Introduction       –       –       –       –       –       –       –       98

5.1    Summary           –       –       –       –       –       –       –       99

5.2    Conclusion –       –       –       –       –       –       –       –       100

5.3    Recommendations      –       –       –       –       –       –       101

REFERENCES

Appendix

Questionnaire

Abstract

Introduction

Sexual risk behaviors (SRB) often lead to sexually transmitted infections (STI), yet little is known about what drives SRB and whether this differs by gender.

Method

Participants (n=920; 75% Caucasian) were drawn from the Raising Healthy Children study, enrolled in 1993 and 1994 in grades 1-2 and followed through age 24/25. Lifetime STI diagnosis was defined by self-report or seropositivity for Chlamydia trachomatis or herpes simplex virus 2. Multivariable models assessed individual (social skills, behavioral disinhibition) and environmental factors (family involvement, school bonding, antisocial friends) predictive of STI diagnosis as mediated by 3 proximal SRB (sex under the influence of drugs or alcohol, condom use, lifetime number of sex partners).

Results

Twenty-five percent of participants had ever had an STI. All SRB differed by gender (p<0.001), and females were more likely to have had an STI (p<0.001). Behavioral disinhibition and antisocial friends in adolescence were associated with more SRB for both genders, whereas social skills were associated with less SRB in females, but more in males. Considering SRB, individual, and environmental factors together, lifetime number of sex partners (ARR=1.04per partner; 95%CI 1.03-1.05) and inconsistent condom use (ARR=1.10per year; 95%CI 1.04-1.16) were associated with increased risk of STI whereas social skills was associated with decreased risk of STI (ARR=0.84; 0.75-0.93). Behavioral disinhibition appeared to drive SRB, but family involvement mitigated this in several cases.

Conclusion

Adolescent environmental influences and individual characteristics drive some SRB and may be more effective targets for STI/HIV prevention interventions than proximal risk behaviors.

HIV/SEXUALLY TRANSMITTED INFECTION PREVENTION MESSAGING: TARGETING ROOT CAUSES OF SEXUAL RISK BEHAVIOR

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