Minnis A M, Moore J G, Doherty I A, Rodas C, Auerswald C, Shiboski S, Padian N S
Women's Global Health Imperative, RTI International, San Francisco, CA 94104, USA.
Am J Epidemiol. 2008 May 1;167(9):1102-9. doi: 10.1093/aje/kwn011. Epub 2008 Feb 27.
Among a cohort of 237 sexually active females aged 14-19 years recruited from community venues in a predominantly Latino neighborhood in San Francisco, California, the authors examined the relation between gang exposure and pregnancy incidence over 2 years of follow-up between 2001 and 2004. Using discrete-time survival analysis, they investigated whether gang membership by individuals and partners was associated with pregnancy incidence and determined whether partnership characteristics, contraceptive behaviors, and pregnancy intentions mediated the relation between gang membership and pregnancy. Pregnancy incidence was determined by urine-based testing and self-report. Latinas represented 77% of participants, with one in five born outside the United States. One quarter (27.4%) became pregnant over follow-up. Participants' gang membership had no significant effect on pregnancy incidence (hazard ratio = 1.25, 95% confidence interval: 0.54, 3.45); however, having partners who were in gangs was associated with pregnancy (hazard ratio = 1.90, 95% confidence interval: 1.09, 3.32). The male partner's perceived pregnancy intentions and having a partner in detention each mediated the effect of partner's gang membership on pregnancy risk. Increased pregnancy incidence among young women with gang-involved partners highlights the importance of integrating reproductive health prevention into programs for gang-involved youth. In addition, high pregnancy rates indicate a heightened risk for sexually transmitted infections.
在从加利福尼亚州旧金山一个主要为拉丁裔的社区场所招募的237名年龄在14至19岁之间的性活跃女性队列中，作者研究了2001年至2004年两年随访期间帮派接触与怀孕发生率之间的关系。他们使用离散时间生存分析，调查个人及其伴侣的帮派成员身份是否与怀孕发生率相关，并确定伴侣特征、避孕行为和怀孕意愿是否介导了帮派成员身份与怀孕之间的关系。怀孕发生率通过尿液检测和自我报告来确定。拉丁裔占参与者的77%，五分之一出生在美国境外。四分之一（27.4%）的参与者在随访期间怀孕。参与者的帮派成员身份对怀孕发生率没有显著影响（风险比=1.25，95%置信区间：0.54，3.45）；然而，伴侣为帮派成员与怀孕相关（风险比=1.90，95%置信区间：1.09，3.32）。男性伴侣的预期怀孕意愿以及伴侣被拘留这两个因素均介导了伴侣的帮派成员身份对怀孕风险的影响。有帮派相关伴侣的年轻女性怀孕发生率增加，这凸显了将生殖健康预防纳入针对有帮派相关经历青年的项目中的重要性。此外，高怀孕率表明性传播感染的风险增加。
