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RESEARCH ARTICLE

Attitudes to sexual health in the United States: results from a national survey of youth aged 15–25 years

Matthew Hogben A D , Christopher Harper B , Melissa A. Habel A , Kathryn Brookmeyer A and Allison Friedman C
+ Author Affiliations
- Author Affiliations

A Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30030, USA.

B Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA 30030, USA.

C Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA 30030, USA.

D Corresponding author. Email: mhogben@cdc.gov

Sexual Health 14(6) 540-547 https://doi.org/10.1071/SH16164
Submitted: 2 September 2016  Accepted: 6 May 2017   Published: 26 June 2017

Abstract

Background: Several common global definitions of sexual health refer to physical, emotional and social well-being, with respect to sexuality, and also to the need for this well-being to be reflected for all individuals in relationships. How well sexual health definitions fit US youths’ attitudes to sexual health, and associations between these attitudes, sexual behaviours and sexual health care were assessed. Methods: In total, 4017 youth aged between 15 and 25 years via an online survey panel, weighted to be representative of the US population, were surveyed. Respondents reported their attitudes towards seven dimensions of sexual health that we abstracted from existing global definitions (emotional fulfillment, social connectedness, spirituality, overall pleasure, physical intimacy, mental fulfillment, reciprocal benefits). Respondents also reported on sexual health-related discussions with partners, sexual behaviours, and their use of sexual health care. Outcomes through weighted frequency estimates and ordinal regression models were reported. Results: Youth generally construed all seven dimensions as important to sexual health, with the emotional dimension rated most favourably. Attitudes to the dimensions of overall pleasure, physical intimacy and spirituality were most consistently related to sexual health discussions and behaviours. The behaviours most consistently related to sexual health attitudes were going for a sexual health check-up, discussing birth control/pregnancy and discussing risk before sex without a condom. Conclusions: Youth construal of sexual health fits well with global sexual health definitions. Attitudes to dimensions of sexual health were related to some sexual health-related behaviours, especially healthcare use and complex discussions.


References

[1]  World Health Organization. Defining sexual health: report of a technical consultation on sexual health: sexual health document series. Geneva: Special Programme of Research, Development and Research Training in Human Reproduction; 2006.

[2]  Centers for Disease Control and Prevention/Health Resources & Services Administration Advisory Committee. HIV and STD prevention and treatment. Paper presented at the HIV and STD Prevention and Treatment Meeting. 8–9 May 2012. Atlanta, GA; 2012.

[3]  Office of the Surgeon General. The Surgeon General’s Call to Action to promote sexual health and responsible sexual behavior. Rockville, MD: Office of the Surgeon General; 2001.

[4]  Hogben M, Ford J, Becasen JS, Brown KF. A systematic review of sexual health interventions for adults: narrative evidence. J Sex Res 2015; 52 444–69.
A systematic review of sexual health interventions for adults: narrative evidence.Crossref | GoogleScholarGoogle Scholar |

[5]  Becasen JS, Ford J, Hogben M. Sexual health interventions: a meta-analysis. J Sex Res 2015; 52 433–43.
Sexual health interventions: a meta-analysis.Crossref | GoogleScholarGoogle Scholar |

[6]  Svanemyr J, Amin A, Robles OJ, Greene ME. Creating an enabling environment for adolescent sexual and reproductive health: a framework and promising approaches. J Adolesc Health 2015; 56 S7–14.
Creating an enabling environment for adolescent sexual and reproductive health: a framework and promising approaches.Crossref | GoogleScholarGoogle Scholar |

[7]  American Academy of Pediatrics. Bright Futures: guidelines for health supervision of infants, children, and adolescents, 3rd edn. Available online at: https://brightfutures.aap.org/Bright%20Futures%20Documents/9-Sexuality.pdf [verified 28 July 2016].

[8]  Chin HB, Sipe TA, Elder RW, Mercer SL, Chattopadhyay SK, Jacob V, Wethington HR, Kirby D, Elliston DB, Griffith M, Chuke SO, Briss SC, Ericksen I, Galbraith JS, Herbst JH, Johnson RL, Kraft JM, Noar SM, Romero LM, Santelli J, Community Preventive Services Task Force The effectiveness of group-based comprehensive risk reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, Human Immunodeficiency Virus, and other sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services. Am J Prev Med 2012; 42 272–94.
The effectiveness of group-based comprehensive risk reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, Human Immunodeficiency Virus, and other sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.Crossref | GoogleScholarGoogle Scholar |

[9]  Public Health Agency of Canada. Canadian guidelines for sexual health education. Ottawa: PHAC; 2008.

[10]  World Association for Sexual Health. Sexual health for the millennium: a declaration and technical document. Minneapolis, MN: World Association for Sexual Health; 2008.

[11]  Haberland N, Rogow D. Sexuality education: emerging trends in evidence and practice. J Adolesc Health 2015; 56 S15–21.
Sexuality education: emerging trends in evidence and practice.Crossref | GoogleScholarGoogle Scholar |

[12]  Oakley A, Fullerton D, Holland J, Arnold S, France-Dawson M, Kelley P, McGrellis S. Sexual health education interventions for young people: a methodological review. BMJ 1995; 310 158–62.
Sexual health education interventions for young people: a methodological review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M7jsFagtQ%3D%3D&md5=9c63efea2a608572cdfe8ac1a50afc32CAS |

[13]  Schalet AT, Santelli JS, Russell ST, Halpern CT, Miller SA, Pickering SS, Goldberg SK, Hoenig JM. Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States. J Youth Adolesc 2014; 43 1595–610.
Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States.Crossref | GoogleScholarGoogle Scholar |

[14]  Hindin MJ, Christiansen CS, Ferguson BJ. Setting research priorities for adolescent sexual and reproductive health in low- and middle-income countries. Bull World Health Organ 2013; 91 10–8.
Setting research priorities for adolescent sexual and reproductive health in low- and middle-income countries.Crossref | GoogleScholarGoogle Scholar |

[15]  Goesling B, Colman S, Trenholm C, Terzian M, Moore K. Programs to reduce teen pregnancy sexually transmitted infections, and associated sexual risk behaviors: a systematic review. J Adolesc Health 2014; 54 499–507.
Programs to reduce teen pregnancy sexually transmitted infections, and associated sexual risk behaviors: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[16]  Higgins JA, Trussell J, Moore NB, Davidson JK. Young adult sexual health: current and prior sexual behaviors among non-Hispanic white US college students. Sex Health 2010; 7 35–43.
Young adult sexual health: current and prior sexual behaviors among non-Hispanic white US college students.Crossref | GoogleScholarGoogle Scholar |

[17]  Higgins JA, Mullinax M, Trussell J, Davidson K, Moore NB. Sexual satisfaction and sexual health among university students in the United States. Am J Public Health 2011; 101 1643–54.
Sexual satisfaction and sexual health among university students in the United States.Crossref | GoogleScholarGoogle Scholar |

[18]  VanDevanter N, Messeri P, Middlestadt SE, Bleakley A, Merzel C, Hogben M, Ledsky R, Malotte CK, Cohall RM, Gift TL, St. Lawrence JS. A community-based approach to increase preventive health care seeking in adolescents: the Gonorrhea Community Action Project. Am J Public Health 2005; 95 331–7.
A community-based approach to increase preventive health care seeking in adolescents: the Gonorrhea Community Action Project.Crossref | GoogleScholarGoogle Scholar |

[19]  Dittus PJ, De Rosa CJ, Jeffries RA, Afifi AA, Cumberland WG, Chung EQ, Martinez E, Kerndt PR, Ethier KA. The Project Connect health systems intervention: linking sexually experienced youth to sexual and reproductive health care. J Adolesc Health 2014; 55 528–34.
The Project Connect health systems intervention: linking sexually experienced youth to sexual and reproductive health care.Crossref | GoogleScholarGoogle Scholar |

[20]  de Visser RO, Badcock PB, Simpson JM, Grulich AE, Smith AM, Richters J, Rissel C. Attitudes toward sex and relationships: The Second Australian Study of Health and Relationships. Sex Health 2014; 11 397–405.
Attitudes toward sex and relationships: The Second Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |

[21]  Mercer CH, Tanton C, Prah P, Erens B, Sonnenberg P, Clifton S, Macdowall W, Lewis R, Field N, Datta J, Copas AJ, Phelps A, Wellings K, Johnson AM. Changes in sexual attitudes and lifestyles through the lifecourse and trends over time: findings from the British National Surveys of Sexual Attitudes and Lifestyles. Lancet 2013; 382 1781–94.
Changes in sexual attitudes and lifestyles through the lifecourse and trends over time: findings from the British National Surveys of Sexual Attitudes and Lifestyles.Crossref | GoogleScholarGoogle Scholar |

[22]  Hensel DJ, Fortenberry JD. A multidimensional model of sexual health and sexual and prevention behavior among adolescent women. J Adolesc Health 2013; 52 219–27.
A multidimensional model of sexual health and sexual and prevention behavior among adolescent women.Crossref | GoogleScholarGoogle Scholar |

[23]  GfK. Knowledge panel design summary. New York: Gfk; 2012. Available online at: http://www.knowledgenetworks.com/knpanel/docs/knowledgepanel(R)-design-summary-description.pdf [verified 28 July 2016].

[24]  McFarlane M, Brookmeyer K, Friedman A, Habel MA, Kachur R, Hogben M. GYT: Get Yourself Tested Campaign awareness: associations with STD/HIV testing and communication behaviors among youth. Sex Transm Dis 2015; 42 619–24.
GYT: Get Yourself Tested Campaign awareness: associations with STD/HIV testing and communication behaviors among youth.Crossref | GoogleScholarGoogle Scholar |

[25]  Nunnally JC, Bernstein IH. Psychometric theory, 3rd edn. New York: McGraw-Hill; 1994.

[26]  Kusunoki Y, Upchurch DM. Contraceptive method choice among youth in the United States: the importance of relationship context. Demography 2011; 48 1451–72.
Contraceptive method choice among youth in the United States: the importance of relationship context.Crossref | GoogleScholarGoogle Scholar |

[27]  Academy for Educational Development. Perceptions of draft and existing chlamydia educational materials: final report from focus groups with females, ages 15–25. Washington, DC: AED; 2010.

[28]  Sinha JW, Cnaan RA, Gelles RJ. Adolescent risk behaviors and religion: findings from a national study. J Adolesc 2007; 30 231–49.
Adolescent risk behaviors and religion: findings from a national study.Crossref | GoogleScholarGoogle Scholar |

[29]  Zaleski EH, Schiaffino KM. Religiosity and sexual risk-taking behavior during the transition to college. J Adolesc 2000; 23 223–7.
Religiosity and sexual risk-taking behavior during the transition to college.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3ovF2qsg%3D%3D&md5=f4ed35c80644e2b66839949995571b4aCAS |

[30]  McCree DH, Wingood GM, DiClemente R, Davies S, Harrington KF. Religiosity and risk sexual behavior in African-American adolescent females. J Adolesc Health 2003; 33 2–8.
Religiosity and risk sexual behavior in African-American adolescent females.Crossref | GoogleScholarGoogle Scholar |

[31]  Park IU, Amey A, Creegan L, Barandas A, Bauer HM. Retesting for repeat chlamydial infection: family planning provider knowledge, attitudes and practices. J Women’s Health 2010; 19 1139–44.
Retesting for repeat chlamydial infection: family planning provider knowledge, attitudes and practices.Crossref | GoogleScholarGoogle Scholar |

[32]  Couper MP. Web surveys – a review of issues and approaches. Public Opin Q 2000; 64 464–94.
Web surveys – a review of issues and approaches.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38%2Fgs1Oqsw%3D%3D&md5=e05369117b64993fc64650f7d4e674ceCAS |