Chambers Rachel Strom, Rosenstock Summer, Lee Angie, Goklish Novalene, Larzelere Francene, Tingey Lauren
International Health, Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, United States.
Front Public Health. 2018 Nov 12;6:318. doi: 10.3389/fpubh.2018.00318. eCollection 2018.
American Indian (AI) youth experience poor sexual health outcomes. Research indicates the Protection Motivation Theory (PMT) is a robust model for understanding how sexual risk and protective behaviors are associated with condom use intention (CUI). Studies indicate the constructs of the PMT which influence CUI vary by sex and sexual experience. This analysis explores associations between PMT constructs and CUI by sex and sexual experience among AI youth who participated in the Respecting the Circle of Life (RCL) trial, a sexual and reproductive health intervention. We analyzed baseline data from the sample of 267 AIs, ages 13-19, who participated in the evaluation. We examined CUI and PMT construct scores by sex and sexual experience utilizing generalized estimated equations and multiple regression models to test which PMT constructs were associated with CUI across sex and sexual experience. Twenty-two percentage of participants were sexually experienced; 56.8% reported CUI at baseline. We found several differences in scores in PMT constructs by sex and sexual experience including self-efficacy, response efficacy, vulnerability, severity, and extrinsic rewards. We also found constructs varied that were associated with CUI varied across sex and sexual experience. No PMT constructs were associated with CUI among sexually experienced youth. Results provide support for developing, selecting and delivering sexual health programs by sex and sexual experience in American Indian communities. Girls programs should focus on internal satisfaction and self-worth while boys should focus on negative impacts of not using condoms. Programs for youth who are not sexually active should focus on negative impacts of not using condoms. Programs for sexually inactive youth should work to change peer norms around condom use and improve knowledge about the efficacy of condom use.
美国印第安（AI）青年的性健康状况不佳。研究表明，保护动机理论（PMT）是理解性风险和保护行为如何与使用避孕套意愿（CUI）相关联的一个有力模型。研究表明，影响CUI的PMT构念因性别和性经历而异。本分析探讨了参与“尊重生命循环”（RCL）试验（一项性与生殖健康干预措施）的AI青年中，PMT构念与CUI之间按性别和性经历的关联。我们分析了参与评估的267名年龄在13 - 19岁的AI样本的基线数据。我们利用广义估计方程和多元回归模型，按性别和性经历检查了CUI和PMT构念得分，以测试哪些PMT构念与不同性别和性经历的CUI相关。22%的参与者有性经历；56.8%的人在基线时报告有CUI。我们发现，在自我效能感、反应效能感、易感性、严重性和外在奖励等PMT构念得分上，按性别和性经历存在一些差异。我们还发现，与CUI相关的构念在不同性别和性经历中各不相同。在有性经历的青年中，没有PMT构念与CUI相关。研究结果为在美国印第安社区按性别和性经历制定、选择和提供性健康项目提供了支持。针对女孩的项目应注重内在满意度和自我价值，而针对男孩的项目应注重不使用避孕套的负面影响。针对没有性活动的青年的项目应注重不使用避孕套的负面影响。针对没有性活动的青年的项目应努力改变关于使用避孕套的同伴规范，并提高对避孕套使用效果的认识。
