Journal of Adolescent Health

Interrupting Intimate Partner Violence in Developing Countries

Venkatraman Chandra-Mouli — 2012-05-01

See Related Article p. 437

Open to the Public: How Adolescents Blur the Boundaries Online Between the Private and Public Spheres of Their Lives

Lucia F. O'Sullivan — 2012-05-01

See Related Article p. 517

Addressing the Critical Health Problem of Adolescent Substance Use Through Health Care, Research, and Public Policy

Emily C. Feinstein, Linda Richter, Susan E. Foster — 2012-05-01

Abstract: The use of addictive substances—tobacco, alcohol, and other drugs—during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care.

Male Adolescents' Attitudes Toward Wife Beating: A Multi-Country Study in South Asia

Koustuv Dalal, Ming Shinn Lee, Mervyn Gifford — 2011-12-05

Abstract: Purpose: This study has aimed to address the gaps in knowledge about male adolescents and their attitudes toward wife beating in multi-country study in Bangladesh, India, and Nepal. Methods: The study used secondary data generated from nationally representative samples of male adolescents (aged 15–19 years) in the demographic and health surveys data in Bangladesh, India, and Nepal. These were household surveys using structured questionnaires, with 275 boys in Bangladesh, 13,078 boys in India, and 939 boys in Nepal. Chi-square tests and logistic regressions were used to assess the associations. Results: In Bangladesh, 42% of 275 respondents had justified wife beating; in India, 51% of 13,078 male adolescents had supported wife beating; and in Nepal, 28% of 939 respondents had supported wife abuse. Individual-level factors, such as rural residency, low educational attainment, low economic status, being unemployed, and having a history of family violence, were positively associated with the justification of wife abuse. Conclusions: This multi-country study indicates a general trend of male adolescents' strong supportive attitude toward wife beating, and hence may suggest that policy makers can specifically target young groups of the population for various interventions for reducing violence against women.

Racial Differences in the Consequences of Childhood Maltreatment for Adolescent and Young Adult Depression, Heavy Drinking, and Violence

2012-02-06

Abstract: Purpose: This study examined racial differences in the consequences of childhood maltreatment for depression, heavy drinking, and violence during adolescence and young adulthood among black and white young men. Methods: Data were obtained from the Pittsburgh Youth Study, a prospective longitudinal study of urban males (N = 971, 56% black). Childhood maltreatment was defined as substantiated physical or sexual abuse, physical neglect, emotional maltreatment, or moral/legal/educational maltreatment, with the first referral before 12 years of age. Self-reports of depressive symptoms and heavy drinking (consuming more than six drinks on a single occasion) and official, parent, and self-reports of violent offending were assessed between 12 and 17 years of age (adolescence) and at 24/25 years of age (young adulthood). Regression analyses were conducted to examine childhood maltreatment and race, as well as maltreatment-by-race interactions, as predictors of the three outcomes. Results: Prevalence of childhood maltreatment was higher for black than for white boys; however, there were no racial differences in timing, type, severity, and chronicity of maltreatment. When socioeconomic status and cohort were controlled, childhood maltreatment significantly predicted depressive symptoms and violence in adolescence but none of the outcomes in young adulthood. Race was a significant predictor of heavy drinking and violence during adolescence, and of all three outcomes in young adulthood. No significant race-by-maltreatment interaction effects were found. Conclusions: Childhood maltreatment has similar negative consequences for black and white male youth during adolescence. Extending intervention efforts through adolescence is important to alleviate these problems among victims.

Romantic Relationship Characteristics and Alcohol Use: Longitudinal Associations With Dual Method Contraception Use

2012-02-06

Abstract: Purpose: Dual method contraception use, or the use of one type of contraceptive intended to prevent pregnancy combined with another type intended to reduce the risk of sexually transmitted infection, may be the most effective method to prevent both unintended pregnancy and sexually transmitted infection. This study tested the association between relationship length, relationship type (married, cohabiting, dating but not cohabiting), global alcohol use, and situational alcohol use and the probability of dual method contraception use from 20 to 23 years of age. Methods: Hierarchical linear modeling analyses were conducted using longitudinal data from 754 sexually active male and female young adults aged 20–23 years. Dependent variables included both any dual method contraception use and consistent dual method contraception use. Results: Between 15% and 20% of respondents reported consistent dual method contraception use at each time point. Longer relationship length and more committed relationship type were associated with a lower probability of both any and consistent dual method contraception use. Situational alcohol use (drinking before sex), but not global alcohol use, also was related to a lower probability of both any and consistent dual method contraception use. Increasing age was associated with a lower probability of any dual method contraception use, but was not related to consistent dual method use. Conclusions: Efforts to promote dual method contraception among young adults should include messages discouraging drinking before sex and supporting dual method use even in the context of committed relationships.

Beyond Age at First Sex: Patterns of Emerging Sexual Behavior in Adolescence and Young Adulthood

Abigail A. Haydon, Amy H. Herring, Mitchell J. Prinstein, Carolyn Tucker Halpern — 2011-11-17

Abstract: Purpose: Although the emergence of sexual expression during adolescence and early adulthood is nearly universal, little is known about patterns of initiation. Methods: We used latent class analysis to group 12,194 respondents from waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) into one of five classes based on variety, timing, spacing, and sequencing of oral-genital, anal, and vaginal sex. Multinomial logistic regression models, stratified by biological sex, examined associations between sociodemographic characteristics and class membership. Results: Approximately half of respondents followed a pattern characterized predominately by initiation of vaginal sex first, average age of initiation of approximately 16 years, and spacing of >1 year between initiation of the first and second behaviors; almost one-third initiated sexual activity slightly later but reported first experiences of oral-genital and vaginal sex within the same year. Classes characterized by postponement of sexual activity, initiation of only one type of behavior, or adolescent initiation of anal sex were substantially less common. Compared with white respondents, black respondents were more likely to appear in classes characterized by initiation of vaginal sex first. Respondents from lower socioeconomic backgrounds were more likely to be in classes distinguished by early/atypical patterns of initiation. Conclusions: A small number of typical and atypical patterns capture the emergence of sexual behavior during adolescence, but these patterns reveal complex associations among different elements of emerging sexuality that should be considered in future research.

Risk Perceptions After Human Papillomavirus Vaccination in HIV-Infected Adolescents and Young Adult Women

2011-11-07

Abstract: Purpose: To examine risk perceptions (perceived risk of human papillomavirus [HPV], perceived risk of other sexually transmitted infections [STIs], and need for safer sexual behaviors) and to determine factors associated with these risk perceptions after HPV vaccination. Methods: Data were collected at the baseline visit of an HPV-6, −11, −16, −18 vaccine clinical trial in 16–23-year-old HIV-infected young women (N = 99). Immediately after receiving the first vaccine dose, participants completed a confidential questionnaire that included three 5-item scales measuring perceived risk of HPV, perceived risk of other STIs, and need for safer sexual behaviors. Linear and logistic regression models were used to examine associations between baseline characteristics (demographic characteristics; cluster of differentiation antigen 4 (CD4+) count; HIV viral load; knowledge about HPV and HPV vaccines; sexual behaviors; and STI diagnosis) and each measure of risk perceptions. Results: Most participants perceived themselves to be at lower risk for HPV (mean scale score = 19.5/50), most perceived that they were not at lower risk for other STIs (mean = 31.2/50), and the vast majority reported that there was still a need for safer sexual behaviors after vaccination (mean = 43.1/50). Multivariate analyses indicated that knowledge about HPV and HPV vaccines was associated with perceived need for safer sexual behaviors (OR = 1.05, 95% CI = 1.0–1.1). Conclusions: Although almost all young women in this study believed that safer sexual behaviors were still important after HPV vaccination, a subset believed they were at less risk for STIs other than HPV. Educational interventions are needed to prevent misperceptions and promote healthy behaviors after vaccination.

Predictors of Highly Active Antiretroviral Therapy Utilization for Behaviorally HIV-1–Infected Youth: Impact of Adult Versus Pediatric Clinical Care Site

2011-11-07

Abstract: Objectives: We evaluated highly active antiretroviral therapy (HAART) utilization in youth infected with HIV through risk behaviors who met treatment criteria for HAART. We assessed the impact of receiving care at an adult or pediatric HIV clinical site on initiation and discontinuation of the first HAART regimen in behaviorally infected youth (BIY). Methods: This was a retrospective analysis of treatment-naive BIY, aged 12–24 years, who enrolled in the HIV Research Network between 2002 and 2008 and who met criteria for HAART. The outcomes were time from meeting criteria to initiation of HAART and time to discontinuation of the first HAART regimen. Analyses were conducted using Cox proportional hazards regression. Results: Of 287 treatment-eligible youth, 198 (69%) received HAART; of these 198 youth, 58 (29.3%) subsequently discontinued HAART. In multivariable analyses, there was no significant difference in the time between meeting treatment criteria and initiating HAART for BIY followed at adult or pediatric HIV clinical sites. However, BIY followed at adult sites discontinued HAART sooner than BIY followed at pediatric HIV clinical sites (adjusted hazard ratio [AHR]: 3.19 [1.26–8.06]). Conclusions: Two-thirds of treatment-eligible BIY in the HIV Research Network cohort initiated HAART; however, one-third who initiated HAART discontinued it during the study period. Identifying factors associated with earlier HAART initiation and sustainability can inform interventions to enhance HAART utilization among treatment-eligible youth. The finding of earlier HAART discontinuation for youth at adult care sites deserves further study.

A Prospective Study of Overeating, Binge Eating, and Depressive Symptoms Among Adolescent and Young Adult Women

Hayley H. Skinner, Jess Haines, S. Bryn Austin, Alison E. Field — 2011-12-13

Abstract: Purpose: To investigate the temporal relationship between depressive symptoms and overeating and binge eating among adolescent and young adult females in the United States. Methods: We investigated incident overeating, binge eating, and depressive symptoms among 4,798 females in the Growing Up Today Study, a prospective cohort study of adolescents and young adults throughout the United States. Participants who reported at least monthly episodes of eating a very large amount of food in a short amount of time in the past year, but not experiencing a loss of control, were classified as overeaters. Those who reported a loss of control while overeating were classified as binge eaters. Depressive symptoms were assessed with the McKnight Risk Factor Survey. Participants were followed between 1999 and 2003. Generalized estimating equations were used for lagged analysis with time-varying covariates. Analyses were adjusted for age, age at menarche, body mass index, and follow-up time. Results: Females reporting depressive symptoms at baseline were two times more likely than their peers to start overeating (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.4, 2.5) and binge eating (OR = 2.3; 95% CI = 1.7, 3.0) during the follow-up. Similarly, females engaging in overeating (OR = 1.9; 95% CI = 1.1, 3.4) or binge eating (OR = 1.9; 95% CI = 1.2, 2.9) at baseline were two times more likely than their peers to develop depressive symptoms during the follow-up. Conclusions: These results indicate that it is important to consider depressive symptoms in overeating and binge eating prevention and treatment initiatives targeting adolescent and young adult females.

Socioeconomic Status and Bone Mass in Spanish Adolescents. The HELENA Study

2011-11-07

Abstract: Purpose: Socioeconomic status (SES) has been frequently associated with body composition, particularly fat mass and obesity. However, the SES-bone mass association is not clear. We aimed to evaluate the associations between different SES indicators (Family Affluence Scale, parental education, and occupation) and bone mineral content in Spanish adolescents. Methods: Participants were 322 adolescents (164 boys and 158 girls, 12.5–17.5 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence study. The social background of the adolescents was self-reported using an SES questionnaire, and the bone variables were measured using dual-energy x-ray absorptiometry. Physical activity was measured using accelerometers. Calcium intake was estimated from two nonconsecutive 24 hours recalls. One-way analysis of covariance was performed to examine the relationships between SES indicators and bone mass using different sets of confounders: basic model (sex + sexual maturation), model 1 (basic model + height), model 2 (basic model + lean mass), and model 3 (basic model + calcium intake + average physical activity). Results: Adjusted results showed no association between SES indicators and whole-body or total hip bone mineral content. Additional analyses were performed in lumbar spine, pelvis, and hip subregions (femoral neck, trochanter, and intertrochanter), and no significant associations were observed at these sites either. Conclusions: Our data do not support a link between different SES indicators (Family Affluence Scale, parental education, and occupation) and bone mass in adolescents.

Longitudinal Trajectories of Metabolic Control Across Adolescence: Associations With Parental Involvement, Adolescents' Psychosocial Maturity, and Health Care Utilization

2011-12-05

Abstract: Purpose: To predict trajectories of metabolic control across adolescence from parental involvement and adolescent psychosocial maturity, and to link metabolic control trajectories to health care utilization. Methods: Two hundred fifty-two adolescents (M age at study initiation = 12.5 years, SD = 1.5, range = 10–14 years) with type 1 diabetes (54.4% female, 92.8% Caucasian, length of diagnosis M = 4.7 years, SD = 3.0, range = 1–12 years) participated in a 2-year longitudinal study. Metabolic control was gathered from medical records every 3 months. Adolescents completed measures of self-reliance (functional autonomy and extreme peer orientation), self-control (self-control and externalizing behavior), and parental involvement in diabetes care (acceptance, monitoring, and frequency of help). At the end of the study, mothers reported health care utilization (diabetes-related emergency room visits and hospitalizations) over the past 6 months. Results: Latent class growth analyses indicated two distinct trajectories of metabolic control across adolescence: moderate control with slight deterioration (92% of the sample; average HbA1c = 8.18%) and poor control with rapid deterioration (8% of the sample; average HbA1c of 12.09%). Adolescents with poor and rapidly deteriorating metabolic control reported lower paternal monitoring and frequency of help with diabetes management, lower functional autonomy, and lower self-control than others. Those with poor and rapidly deteriorating metabolic control were 6.4 times more likely to report diabetes-related emergency room visits, and 9.3 times more likely to report diabetes-related hospitalizations near the end of the study. Conclusions: Parental involvement and adolescents' psychosocial maturity predict patterns of deteriorating metabolic control across adolescence and could be targeted for intervention.

Cardiorespiratory Fitness and Proximity to Commercial Physical Activity Facilities Among 12th Grade Girls

2012-02-06

Abstract: Purpose: To investigate the relationship between proximity to commercial physical activity (PA) facilities and cardiorespiratory fitness of 12th grade girls. Methods: Adolescent girls (n = 786, 60% African American, mean age = 17.6 ± .6 years) performed a submaximal fitness test (Physical Work Capacity 170 test). Commercial PA facilities were mapped and counted within a .75-mile street-network buffer around girls' homes using Geographic Information Systems. Sedentary activities and vigorous physical activity (≥6 metabolic equivalents) were determined by the average number of 30-minute blocks reported per day on the 3-Day Physical Activity Recall. Mixed model regressions were calculated using school as a random variable. Results: Girls had higher weight-relative Physical Work Capacity 170 test scores if there was a commercial PA facility (n = 186, 12.4 ± 4.2 kg m/min/kg) within a .75-mile street-network buffer of home as compared with girls without a nearby facility (n = 600, 11.2 ± 3.6 kg m/min/kg). After adjusting for demographic variables, sports participation, sedentary behaviors, and vigorous physical activity, having one or more commercial PA facilities within a .75-mile street-network buffer of homes was significantly related to cardiorespiratory fitness. Conclusions: Both with and without adjustment for covariates, the presence of a commercial PA facility within a .75-mile street-network buffer of a girl's home was associated with higher cardiorespiratory fitness.

Bidirectional Prospective Associations Between Physical Activity and Depressive Symptoms. The TRAILS Study

Nikolaos Stavrakakis, Peter de Jonge, Johan Ormel, Albertine J. Oldehinkel — 2011-11-07

Abstract: Purpose: Low levels of physical activity (PA) have been shown to be associated with depression in adults. The few studies that focused on adolescents yielded mixed and inconsistent results. Efforts to examine the direction of this relationship have been inconclusive up to now. The aims of this study were therefore to investigate (1) the direction of the inverse association between PA and depressive symptoms over time, and (2) whether these associations are specific to particular clusters of depressive symptoms in adolescents. Methods: Depressive symptoms and PA were assessed in a population sample of adolescents (N = 2,230) who were measured at three waves between age 10 and age 17. Depressive symptoms were measured by the Affective Problems scale of the Youth Self-Report and Child Behavior Checklist, whereas PA was operationalized as the amount of time spent on physical exercise. Structural equation modeling was used to examine bidirectional effects of PA and depressive symptoms over time. Results: We found significant cross-lagged paths from prior PA to later depression as well as from prior depression to later PA (beta values = −.039 to −.047). After subdividing depression into affective and somatic symptoms, the affective symptoms were reciprocally related to PA, whereas the paths between somatic symptoms and PA did not reach statistical significance. Conclusions: An inverse bidirectional association between PA and general depressive symptoms was observed. This association was restricted to affective symptoms.

Low Back Pain and Comorbidity Clusters at 17 Years of Age: A Cross-sectional Examination of Health-Related Quality of Life and Specific Low Back Pain Impacts

2012-02-06

Abstract: Purpose: Comorbidities in adults negatively affect the course of low back pain (LBP). Little is known of the presence and/or impact of LBP comorbidities in adolescents. Methods: Subjects from the Raine Study cohort at age 17 years (n = 1,391) provided self-report of diagnosed medical conditions/health complaints, health-related quality of life (36-Item Short Form Health Survey [SF-36]), lifetime experience of LBP, and specific LBP impacts (taking medication, missing school/work, interference with normal/physical activities). Latent class analysis was used to estimate clusters of comorbidities based on diagnosed disorders. Profiles of SF-36 and impact were examined between clusters. Results: Four distinct comorbidity clusters were identified: cluster 1: Low probability of diagnosed LBP or any other medical condition (79.7%); cluster 2: High probability of diagnosed LBP and neck/shoulder pain, but a low probability of other diagnosed health conditions (9.6%); cluster 3: Moderate probability of diagnosed LBP and high probability of diagnosed anxiety and depression (6.9%); cluster 4: Moderate probability of diagnosed LBP and high probability of diagnosed behavioral and attention disorders (3.8%). The clusters had different SF-36 and LBP impact profiles, with clusters 3 and 4 having poorer SF-36 scores, and clusters 2 to 4 having greater risk for specific LBP impacts, than cluster 1. Conclusions: Identified comorbidity clusters support adolescent and adult studies reporting associations between LBP, other pain areas, psychological disorders, and disability. Tracking these clusters into adulthood may provide insight into health care utilization in later life, whereas identification of these individuals early in the life span may help optimize intervention opportunities.

Adolescents' Self-presentation on a Teen Dating Web Site: A Risk-Content Analysis

Melissa A. Pujazon-Zazik, Stephanie M. Manasse, Joan K. Orrell-Valente — 2012-02-29

Abstract: Purpose: To analzye adolescents' profiles on MyLol.net, a teen dating Web site, for risk content. We hypothesized that risk content would vary by age and gender. Methods: We selected and coded 752 publicly viewable profiles of adolescents aged 14–18 years for the following five risks: sex, alcohol, drugs, cigarettes, and violence. Results: Of the total profiles, 27.7% contained risk-related content: 15.8% sexual behavior, 13.8% alcohol use, 1.6% drug use, 6.8% cigarette smoking, and .9% violence activity. Being female, “single” relationship status, and use of profanity (p < .05) were associated with risk content. Conclusions: Females' profiles were most likely to include risky content, especially sexual content. Adolescent females who have internalized social norms that place a high value on female sexuality may reflect this in their online profiles. Online mention of interest/involvement in risky behavior may have negative consequences (e.g., cyberbullies and sexual predators). Stronger universal Internet policies and education are needed to help protect adolescents.

Cyber and Bias-based Harassment: Associations With Academic, Substance Use, and Mental Health Problems

2012-02-06

Abstract: Purpose: To examine how two forms of interstudent harassment, cyber and bias-based harassment, are associated with academic, substance use, and mental health problems. Methods: We used a population-based survey of 17,366 middle and high school students that assessed harassment due to race/ethnicity or sexual orientation, and harassment through the Internet or text messaging along with other forms of interstudent harassment. Results: Odds ratios indicated that students experiencing both cyber and bias-based harassment were at the greatest risk for adjustment problems across all indicators, with suicidal ideation and attempts having the largest risk differences. Conclusions: Assessments of adolescent health and adjustment should include questions regarding both cyber and bias-based harassment.

Suicidal Ideation and Self-Harm Behavior in a Community Sample of Preadolescent Youth: A Case-Control Study

2011-12-06

Abstract: Objective: Research has focused on understanding risk factors associated with suicidal ideation and self-harm behaviors in older youth, but less is known regarding these behaviors in preadolescents. We examined characteristics associated with suicidal ideation and self-harm behavior in youth aged 10–13 years. Design/Methods: A community sample of 387 youth was enrolled in a prospective study assessing precursors of risk behaviors. Twenty-three subjects endorsing items regarding suicidal ideation or self-harm behaviors (Achenbach's Youth Self-Report) (endorsers) were matched with 23 non-endorsers. Groups were compared on problem behaviors, impulsivity, neurocognitive function, risk behaviors, and other variables. Results: Endorsers had higher levels of impulsivity, were more likely in borderline/clinical range on 5 of 8 Youth Self-Report Syndrome scales, and reported more risk taking. Endorsers and non-endorsers were similar in neurocognitive function. More non-endorsers were on stimulants, but groups were similar in parental monitoring and parental report of behavioral/emotional issues, socioeconomic status, and marital status. Conclusion: In this study, preadolescent endorsers report significantly more problem behaviors than non-endorsers. However, parental monitoring and parent report of problems were similar between groups. Given these findings, we suggest that at-risk youth may be underrecognized at young ages.

“What if You Already Know Everything About Sex?” Content Analysis of Questions From Early Adolescents in a Middle School Sex Education Program

Linda Charmaraman, Alice J. Lee, Sumru Erkut — 2012-02-06

Abstract: Purpose: To assess sixth graders' knowledge and curiosity about sex-related topics that can guide the development of sexual health education and healthcare delivery. Methods: Sixth graders (n = 795) in eight ethnically diverse schools participating in an evaluation of a sex education curriculum submitted 859 anonymous questions that were content analyzed. The χ2 analysis examined whether the themes varied by coed/single-sex environments or by school-level sexual risk. Results: Sexual activity, female anatomy, reproduction, and puberty were the most frequently mentioned topics, whereas, questions on STIs, sexual violence, and drug/alcohol use were fewer. Questions that avoided sexual topics came from lower sexual-risk schools; students at higher-risk schools asked about sexual initiation, contraception, vaginal and anal sex, general health, and pain during sex. Single-sex classrooms elicited more direct and explicit questions about sex. Conclusions: The results are relevant to educators and healthcare providers who ask and answer questions from early adolescents regarding sexual health.

Diffuse Peritoneal Chlamydial Infection Presenting as Possible Ovarian Peritoneal Carcinomatosis in an Adolescent Female

2012-02-06

Abstract: A 17-year-old girl presented with significant abdominal ascites associated with periumbilical pain. On examination, her abdomen was found to be soft and moderately distended with left lower quadrant tenderness. Abdominal computed tomographic scan demonstrated not only ascites but also diffuse peritoneal enhancement, a left-sided enhancing adnexal mass displacing the uterus to the right, as well as omental caking. Alpha fetoprotein level was normal, whereas carcinoembryonic antigen (3.4 ng/mL) and cancer antigen 125 (315 U/mL) were mildly elevated. Based on these findings, a presumptive diagnosis of peritoneal carcinomatosis of ovarian origin was made. However, intraoperative biopsy of the left adnexal mass showed only a lymphoplasmacytic infiltrate. Chlamydial polymerase chain reaction of an intraoperative cervical sample was positive, and the final diagnosis was complicated pelvic inflammatory disease. The patient responded well to a prolonged course of antibiotics.

Rationale for Reducing the Spread of Human Papillomavirus in Adolescents: Strategies to Improve Outcomes (CME Multimedia Activity)

Kenneth Alexander, Alison Moriarty Daley, Amanda Frisch Dempsey — 2012-05-01

Abstract: As detailed in this online CME activity (http://cmeaccess.com/cme/JAH_HPV_program/index.asp?link_id=2), human papillomavirus (HPV) infection is the cause of cervical cancer and neoplasias in women, and genital warts in men and women. In addition, 35%–85% of vaginal, vulvar, anal, penile, and oropharyngeal cancers are attributable to HPV. An estimated 80% of females and 50% of males in the United States will become infected at some point in their lives; however, the incidence of this highly prevalent infection peaks in adolescents and young adults. Owing to the importance of vaccination before this elevated risk of exposure, the Centers for Disease Control and Prevention recommends HPV vaccination for girls aged 11–12 years with either the bivalent or quadrivalent vaccine. Recently, the quadrivalent vaccine, which also protects against genital warts and anal neoplasias and cancer, was approved for use in boys as well. Although the coverage rate has increased steadily in the 5 years since the vaccine's introduction, it remains below 50%. To overcome barriers to vaccination, including lack of awareness about adolescents' HPV risk and challenges associated with preventive care in this age group in general, healthcare providers must be able to educate parents/patients about HPV and the vaccine, as well as maximize opportunities to vaccinate adolescents at every office visit.

Editorial Board

2012-05-01

Journal of Adolescent Health

Interrupting Intimate Partner Violence in Developing Countries

Open to the Public: How Adolescents Blur the Boundaries Online Between the Private and Public Spheres of Their Lives

Addressing the Critical Health Problem of Adolescent Substance Use Through Health Care, Research, and Public Policy

Male Adolescents' Attitudes Toward Wife Beating: A Multi-Country Study in South Asia

Racial Differences in the Consequences of Childhood Maltreatment for Adolescent and Young Adult Depression, Heavy Drinking, and Violence

Romantic Relationship Characteristics and Alcohol Use: Longitudinal Associations With Dual Method Contraception Use

Beyond Age at First Sex: Patterns of Emerging Sexual Behavior in Adolescence and Young Adulthood

Risk Perceptions After Human Papillomavirus Vaccination in HIV-Infected Adolescents and Young Adult Women

Predictors of Highly Active Antiretroviral Therapy Utilization for Behaviorally HIV-1–Infected Youth: Impact of Adult Versus Pediatric Clinical Care Site

A Prospective Study of Overeating, Binge Eating, and Depressive Symptoms Among Adolescent and Young Adult Women

Socioeconomic Status and Bone Mass in Spanish Adolescents. The HELENA Study

Longitudinal Trajectories of Metabolic Control Across Adolescence: Associations With Parental Involvement, Adolescents' Psychosocial Maturity, and Health Care Utilization

Cardiorespiratory Fitness and Proximity to Commercial Physical Activity Facilities Among 12th Grade Girls

Bidirectional Prospective Associations Between Physical Activity and Depressive Symptoms. The TRAILS Study

Low Back Pain and Comorbidity Clusters at 17 Years of Age: A Cross-sectional Examination of Health-Related Quality of Life and Specific Low Back Pain Impacts

Adolescents' Self-presentation on a Teen Dating Web Site: A Risk-Content Analysis

Cyber and Bias-based Harassment: Associations With Academic, Substance Use, and Mental Health Problems

Suicidal Ideation and Self-Harm Behavior in a Community Sample of Preadolescent Youth: A Case-Control Study

“What if You Already Know Everything About Sex?” Content Analysis of Questions From Early Adolescents in a Middle School Sex Education Program

Diffuse Peritoneal Chlamydial Infection Presenting as Possible Ovarian Peritoneal Carcinomatosis in an Adolescent Female

Rationale for Reducing the Spread of Human Papillomavirus in Adolescents: Strategies to Improve Outcomes (CME Multimedia Activity)

Editorial Board

Table of contents