To identify predictors of conceiving a pregnancy, over a 6-month observation period, among young black males attending clinics that diagnose and treat sexually transmitted infections).
Methods:
A convenience sample was recruited from clinics in three U.S. cities. Young black males aged 15–23 years (n=286) who reported recent (past 2 months) penetrative sex and had not conceived a pregnancy at enrollment were eligible. At baseline and 6-month follow-up, participants completed self-interview surveys and provided a urine sample for gonorrhea and chlamydia testing. Associations of conceiving a pregnancy with demographic, behavioral, and psychosocial predictors were assessed using bivariate and adjusted logistic regression models.
Results:
At the 6-month follow-up 11.5% conceived a pregnancy during the observation period. Bivariate analysis indicated testing positive for chlamydia and/or gonorrhea at study enrollment significantly increased odds of conceiving a pregnancy (p=0.01). Enrollment in school was a protective factor (p<0.04). Adjusted logistic regression modeling demonstrated that males with a history of arrest were three times more likely to conceive a pregnancy (adjusted odds ratio [AOR]=3.63, 95% confidence interval [CI]=1.71–7.77; p=0.001). For every added unit of agreement that “somebody wants to be pregnant with your child,” odds of conceiving during the observation period increased by 37% (AOR=1.53, 95% CI=1.19–1.98; p<0.001).
Conclusion:
Findings suggest incident conceptions among a clinic-based sample of young black males occurred at a high rate, regardless of age. The clinic setting provides a unique opportunity to intervene with this population of would-be fathers, potentially making a valuable contribution to overall efforts to remedy racial disparities in adolescent/young adult pregnancy rates.
Centers for Disease Control and Prevention. A heightened national response to the HIV/AIDS crisis among African Americans. Atlanta, GA: CDC, 2007. Available at: www.cdc.gov/news/2007/03/hiv_african_americans.html Accessed June26, 2014.
3.
Office of National AIDS Policy. National HIV/AIDS strategy for the United States 2010. Washington DC, 2010. Available at www.whitehouse.gov/administration/eop/onap/nhas Last accessed June26, 2014.
4.
Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2012. Atlanta: U.S. Department of Health and Human Services, 2013.
5.
Centers for Disease Control and Prevention. Fact sheet: HIV and AIDS among African Americans. Atlanta: U.S. Department of Health and Human Services, 2014.
DjambaYK, DavidsonTC, AgaM. Sexual health of young people in the U.S. South: challenges and opportunities. Montgomery, AL: Center for Demographic Research, 2012.
CarrJH, KuttyNK, Segregation: The rising costs for America. New York: Routledge, 2010.
10.
AdimoraAA, SchoenbachVJ, DohertyIA. HIV and African Americans in the southern United States: Sexual networks and social context. Sex Transmit Diseases, 2006; 33:S39–S45.
11.
HenlyJR. The complexity of support: The impact of family structure and provisional support on African American and white adolescent mothers' well-being. Am J Community Psychol, 1997; 25:629–655.
12.
WilsonWJ. The truly disadvantaged: The inner city, the underclass, and public policy. Chicago: University of Chicago Press, 1987.
13.
JessorR, DonovanJE, CostaFM. Beyond adolescence: Problem behaviors and young adult development. Cambridge, UK: Cambridge University Press, 1991.
14.
SalazarLF, HeadS, CrosbyRA, et al.Personal and social influences regarding oral sex among African American female adolescents. J Womens Health (Larchmt), 2011; 20:161–167.
15.
De GraafH, VanwesenbeeckI, MeijerS, WoertmanL, MeeusW. Sexual trajectories during adolescence: Relation to demographic characteristics and sexual risk. Arch Sex Behav, 2009; 38:276–282.
16.
CrosbyRA, DiClementeRJ, WingoodGM, SalazarLF, RoseE, SalesJM. The protective value of school enrolment against sexually transmitted disease: a study of high-risk African American adolescent females. Sex Transm Infect, 2007; 83:223–227.
17.
BelenkoS, DemboR, WeilandD, et al.Recently arrested adolescents are at high risk for sexually transmitted diseases. Sex Transm Dis, 2008; 35:758–763.
18.
ForrestCB, TamborE, RileyAW, EnsmingerME, StarfieldB. The health profile of incarcerated male youths. Pediatrics, 2000; 105:286–291.
19.
CrosbyRA, DiClementeRJ, WingoodGM, et al.HIV/STD-protective benefits of living with mothers in perceived supportive families: A study of high-risk African American female teens. Prev Med (Baltim), 2001; 33:175–178.
20.
CrosbyRA, DiClementeRJ, WingoodGM, HarringtonK. HIV/STD prevention benefits of living in supportive families: a prospective analysis of high risk African-American female teens. Am J Health Promot, 16:142–145.
21.
DaviesS, CrosbyRA DR. Family influences on adolescent health. In: DiClementeRJ, SantelliJS CR, eds. Adolescent health: Understanding and preventing risk behaviors. San Francisco, CA: Jossey-Bass Wiley, 2009. p. 391–410.
22.
CrosbyRA, DiClementeRJ, WingoodGM, et al.Low parental monitoring predicts subsequent pregnancy among African-American adolescent females. J Pediatr Adolesc Gynecol, 2002; 15:43–46.
23.
DiClementeRJ, WingoodGM, CrosbyR, et al.Parental monitoring: association with adolescents' risk behaviors. Pediatrics, 2001; 107:1363–1368.
24.
CrosbyR, VoisinD, SalazarLF, DiClementeRJ, YarberWL, CaliendoAM. Family influences and biologically confirmed sexually transmitted infections among detained adolescents. Am J Orthopsychiatry, 2006; 76:389–394.
25.
The National Campaign to Prevent Teen and Unplanned Pregnancy. The DCR Report. Available at: http://thenationalcampaign.org Accessed June30, 2014.
26.
Centers for Disease Control and Prevention. National survey of family growth: Fertility of men and women aged 15–44 years in the United States, 2006–2010. Atlanta: CDC/National Center for Health Statistics; 2012.
27.
HarrisKM, FurstenbergFF, MarmerJK. Paternal involvement with adolescents in intact families: The influence of fathers over the life course. Demography, 1998; 35:201–216.
28.
Pirog-GoodMA. The family background and attitudes of teen fathers. Youth Society, 1995; 26:351–76.
29.
FurstenbergFFJr, Brooks-GunnJ, Chase-LansdaleL. Teenaged pregnancy and childbearing. Am Psychologist, 1989; 44:313.
30.
LukerK. Dubious conceptions: The politics of teenage pregnancy. Cambridge, MA: Harvard University Press, 1996.
CrosbyRA, NoarS, HeadS, WebbE. Condoms and other barrier methods of STI and HIV prevention. In: KumarSG & KumarB, (eds). Sexually transmitted infections, 2nd ed. New Delhi: Elsevier India; 2011:1174–91.
33.
CrosbyR, SandersS, YarberWL, GrahamCA. Condom-use errors and problems. Am J Prev Med, 2003; 24:367–370.
34.
SandersSA, YarberWL, KaufmanEL, CrosbyRA, GrahamCA, MilhausenRR. Condom use errors and problems: A global view. Sex Health, 2012; 9:81–95.
35.
Centers for Disease Control and Prevention. Clinical prevention guidance. Sexually transmitted diseases treatment guidelines 2006. Morb Mortal Wkly Rep, 2006; 55:2–6.
36.
AndersonJE, SantelliJ, GilbertBC. Adolescent dual use of condoms and hormonal contraception: trends and correlates 1991–2001. Sex Transmit Diseases, 2003; 30:719–722.
37.
WingoodGM, DiClementeRJ. Partner influences and gender-related factors associated with noncondom use among young adult African American women. Am J Comm Psychol, 1998; 26:29–51.
38.
WingoodGM, DiClementeRJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Educ Behav, 2000; 27:539–565.
39.
DaleyAM. What influences adolescents' contraceptive decision-making? a meta-ethnography. J Ped Nursing, 2014. [Epub ahead of print]; DOI: 10.1016/j.pedn.2014.05.001.
40.
FinerLB, HenshawSK. Disparities in rates of unintended pregnancy in the united states, 1994 and 2001. Perspect Sex Reprod Health, 2006; 38:90–96.
41.
VenturaSA, AbmaJC, MosherWD, HenshawS. Estimated Pregnancy rates by outcome for the United States, 1990–2004. Natl Vital Stat Reports, 2008; 56.
42.
Stevens-SimonC. Adolescent pregnancy. In: DiClementeRJ, HansenWB P LE, ed. Handbook of adolescent risk behavior. New York: Plenum Press, 1996.
43.
US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for HIV, STI and TB Prevention (NCHSTP), Division of STI/HIV Prevention. Sexually transmitted disease morbidity for selected STIs by age, race/ethnicity and gender 1996–2009. Available at http://wonder.cdc.gov/STI-v2009-race-age.html Last accessed June30, 2014.
44.
KostK, HenshawS, CarlinL. U.S. Teenage pregnancies, births and abortions: National and state trends and trends by race and ethnicity. Washington, DC: Guttmacher Institute, 2010.
45.
CrosbyR, DiClementeRJ, CharnigoR, SnowG, TroutmanA. A brief, clinic-based, safer sex intervention for heterosexual African American men newly diagnosed with an STD: A randomized controlled trial. Am J Public Health, 2009; 99:S96–S103.
46.
Stouthamer-LoeberM, WeiEH. The precursors of young fatherhood and its effect on delinquency of teenage males. J Adoles Health, 1998; 22:56–65.
47.
Penman-AguilarA, CarterM, SneadMC, KourtisAP. Socioeconomic disadvantage as a social determinant of teen childbearing in the US. Public Health Rep, 2013; 128(Suppl 1):5.
48.
WilsonWJ. When work disappears: The world of the new urban poor. New York: Knopf; 1996.
49.
WilsonWJ. The truly disadvantaged: The inner city, the underclass, and public policy. Chicago: University of Chicago Press; 1987.
50.
SucoffCA, UpchurchDM. Neighborhood context and the risk of childbearing among metropolitan-area black adolescents. Am Soc Rev, 1998; 63:571–585.
51.
MasseyDS, ShibuyaK. Unraveling the tangle of pathology: the effect of spatially concentrated joblessness on the well-being of African Americans. Soc Sci Res, 1995; 24:352–366.
52.
SouthSJ, BaumerEP. Deciphering community and race effects on adolescent premarital childbearing. Social Forces, 2000; 78:1379–407.
53.
ThornberryTP, WeiEH, Stouthamer-LoeberM, Van DykeJ. Teenage fatherhood and delinquent behavior. Juvenile Justice Bulletin, Youth Development Series No. 178899. Washington, DC: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, 2000.
54.
ElderGHJr.The life course and human development. In: DamonW, series ed., and LernerRM, ed., Handbook of child psychology: Vol 1. Theoretical models of human development. New York: John Wiley, 1998.
55.
SampsonRJ, LaubJH. A life-course development of crime. Annals AmAcademy of Political Soc Sciences, 2005; 602:12–45.
56.
EdinK, NelsonTJ, ParanalR. Fatherhood and incarceration as potential turning points in the criminal careers of unskilled men. Evanston, IL: Institute for Policy Research, Northwestern University, 2001.
57.
U.S. Department of Justice. OJJDP fact sheet: Highlights of findings from the Pittsburgh Youth Study. 1999.
58.
AronsonRE, RulisonKL, GrahamLF, et al.Brothers Leading Healthy Lives: Outcomes from the pilot testing of a culturally and contextually congruent HIV prevention intervention for black male college students. AIDS Educ Prev, 2013; 25:376–393.
59.
Centers for Disease Control and Prevention. Effective interventions: HIV prevention that works. Atlanta, GA; 2010.
60.
CrosbyRA, SalazarLF, YarberWL, et al.A theory-based approach to understanding condom errors and problems reported by men attending an STI clinic. AIDS Behav, 2008; 12:412–418.
61.
DiClementeRJ, WingoodGM, RoseES, et al.Efficacy of sexually transmitted disease/human immunodeficiency virus sexual risk-reduction intervention for African American adolescent females seeking sexual health services: a randomized controlled trial. Arch Pediatr Adolesc Med, 2009; 163:1112–1121.
62.
JemmottJB, JemmottLS, BravermanPK, FongGT. HIV/STD risk reduction interventions for African American and Latino adolescent girls at an adolescent medicine clinic: A randomized controlled trial. Arch Pediatr Adolesc Med, 2005; 159:440–449.
63.
JonesKT, GrayP, WhitesideYO, et al.Evaluation of an HIV prevention intervention adapted for Black men who have sex with men. Am J Public Health, 2008; 98:1043–1050.
64.
JohnsonWD, DiazRM, FlandersWD, et al.Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev, 2008; 3:CD001230.
65.
KennedySB, NolenS, PanZ, SmithB, ApplewhiteJ, VanderhoffKJ. Effectiveness of a brief condom promotion program in reducing risky sexual behaviours among African American men. J Eval Clin Pract, 2013; 19:408–413.
66.
PetersonJL, CoatesTJ, CataniaJ, et al.Evaluation of an HIV risk reduction intervention among African-American homosexual and bisexual men. AIDS, 1996; 10:319–325.
67.
WiltonL, HerbstJH, Coury-DonigerP, et al.Efficacy of an HIV/STI prevention intervention for black men who have sex with men: Findings from the Many Men, Many Voices (3MV) project. AIDS Behav, 2009; 13:532–544.
68.
RimalRN. How behaviors are influenced by perceived norms: A test of the theory of normative social behavior. Communic Res, 2005; 32:389–414.
69.
PriceV. Public opinion processes. In: BergerCR, ed. Handbook of communication science. Newbury Park, CA: Sage Publications, 1987.
70.
AndersonE. Sex codes and family life among poor inner-city youths. In: LermanRI, OomsTJ, (eds). Young unwed fathers: Changing roles and emerging policies. Temple University Press, 2009.
71.
DeJongW, SchneiderSK, TowvimLG, et al.A multisite randomized trial of social norms marketing campaigns to reduce college student drinking. J Stud Alcohol Drugs, 2006; 67:868.
72.
FossRD, MarchettiLJ, HolladayKA. Development and evaluation of a comprehensive program to reduce drinking and impaired driving among college students. U.S. Department of Transportation (DOT) No. HS-809 396. Washington, DC: DOT, 2001
73.
PerkinsHW, CraigDW. A successful social norms campaign to reduce alcohol misuse among college student-athletes. J Stud Alcohol Drugs, 2006; 67:880.
74.
AbmaJC, MartinezG, CopenCE. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, National Survey of Family Growth, 2006–2008. Vital Health Stat, 2010; 23:1–47.
75.
MatthewsTJ, SuttonPD, HamiltonBE, VenturaS. State disparities in teenage birth rates in the United States. NCHS data brief, No. 46. Hyattsville, MD: National Center for Health Statistics, 2010.
76.
BrewsterK. Race differences in sexual activity among adolescent women: The role of neighborhood characteristics. Am Sociol Rev, 1994; 59:408–424.
