As adolescents develop intimate relationships skills, they might change romantic partners often. ... more As adolescents develop intimate relationships skills, they might change romantic partners often. Little is known about this developmental phenomenon. The goal was to determine the frequency of non-exclusive romantic relationships in girls, the variables associated with non-exclusive relationships, and the variables associated with having sexual intercourse in a non-exclusive relationship. Girls (12-15 years of age) participated in a longitudinal study (3 y, 7 visits) of romantic relationships. Seventy-two of 160 girls had a non-exclusive relationship, and of these, 23 girls had intercourse in an outside relationship. Younger age, belief that the boyfriend had an outside relationship, and less parental indirect monitoring was associated with the girl having an outside relationship. A longer time being sexually experienced and less direct parental monitoring was associated with having intercourse in the outside relationship. Non-exclusivity in adolescence is common but does not always include sexual intercourse. Healthcare providers can address non-exclusivity with adolescents directly.
Adolescent girls could benefit from topical microbicide use if the product is acceptable to them.... more Adolescent girls could benefit from topical microbicide use if the product is acceptable to them. The goal was to evaluate girls', mothers', experienced healthcare providers', and medical students' views on timing of use, efficacy, and safety of topical microbicide use by adolescents. Focus groups were conducted with girls, mothers, healthcare providers, and medical students. All groups were videotaped, transcribed, and coded for relevant themes. A delay between insertion and coitus presented a problem, and pre- and postcoital use had advantages depending on the group. Efficacy was evaluated by timing of use, smell, ability to feel the product, and confidence that it would spread sufficiently. There were concerns about physical side effects and the impact on normal vaginal flora. This study demonstrated the importance of understanding the unique needs and perspectives of adolescent girls and the adults who have an influence on their use.
Purpose: Topical microbicides could be a female-controlled method for prevention of sexually tran... more Purpose: Topical microbicides could be a female-controlled method for prevention of sexually transmitted diseases (STDs). Microbicides could offer girls a potential preventive option, if they are able to access them. The purpose of this investigation was to evaluate girls', mothers', experienced healthcare providers', and medical students' views on adolescent girls' obtaining information about and acquiring microbicides and where adolescent girls would keep or carry a microbicide. Methods: Focus groups were conducted and videotaped with each group of individuals. The videotapes were transcribed, and the transcriptions were coded for relevant themes. Results: Participants anticipated that adolescents would learn about microbicides from a variety of sources and that specific educational efforts for each of these sources (mothers, healthcare providers, and school-based sexuality education) would be needed. Healthcare providers stressed the importance of enhancing access by having both prescription and overthe-counter (OTC) options. For nonprescription products, the participants felt that the microbicide should be in stores and venues to which adolescents typically go by themselves. A microbicide that was girl-friendly and adolescent-friendly consistently was highlighted by the participants. Participants thought this would increase discretion and decrease embarrassment. The location of keeping and carrying the microbicide was anticipated to be dependent on parents' knowledge of their adolescent's sexuality and the likelihood that parents search their adolescent's belongings. Conclusions: Consideration of the adolescent-specific issues in the design of microbicides and marketing strategies may be crucial for adolescent adoption of this female-controlled method.
Journal of Developmental & Behavioral Pediatrics, 2003
Predictors of health-related quality of life (HR-QOL) among inner-city girls and its effect on he... more Predictors of health-related quality of life (HR-QOL) among inner-city girls and its effect on health care use were evaluated. Adolescent girls aged 14 to 18 years (n = 127) completed a demographic and riskbehavior interview, the Kaufman Brief Intellectual Test, and the Medical Outcomes Study Short Form-36. Medical charts were reviewed for health care use. Two assessments were completed 6 months apart. Participants reported stable and poor HR-QOL compared with norms for similar aged females. HR-QOL was associated with some concurrent risk taking. Lower self-perceptions of mental health were associated with inconsistent condom use, smoking, and alcohol use; lower self-perceptions of physical health were associated with pregnancy and smoking. Predictive associations were not found. There was a trend for poorer physical health to be associated with more clinic visits. This study highlights the need for research aimed at both improving self-perceptions of health and decreasing high-risk behavior among inner-city girls.
Background. Cross-sectional seroprevalence studies indicate that infections with herpes simplex v... more Background. Cross-sectional seroprevalence studies indicate that infections with herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2) and cytomegalovirus (CMV) are common. However, data on the rates of acquisition of these infections are limited. Methods. A 3-year longitudinal study of HSV-1, HSV-2, and CMV seroprevalence was conducted in a cohort of 174 adolescent girls (age at enrollment, 12-15 years). Results. At study entry, 41% of the girls reported a history of sexual activity, and by the end of the study, 73% reported a history of sexual activity. At enrollment, 71% of all participants were seropositive for CMV, 44% were seropositive for HSV-1, and 7% were seropositive for HSV-2. By the end of the study, 81% of the girls were seropositive for CMV, 49% were seropositive for HSV-1, and 14% were seropositive for HSV-2. Among girls with a history of sexual activity, 15.5% were HSV-2 seropositive at the beginning of the study, and 18.9% were HSV-2 seropositive at the end of the study. The attack rates, based on the number of cases per 100 person-years, were 13.8 for CMV infection and 3.2 for HSV-1 infection (among all girls) and 4.4 for HSV-2 infection (among girls with a history of sexual activity). Participants with preexisting HSV-1 antibodies were associated with a significantly lower attack rate for HSV-2 infection. A generalized estimating equation model indicated that participants with a longer history of sexual activity and those who had more sexually transmitted diseases during the 6-month periods before the study visits were more likely to be HSV-2 seropositive. Conclusions. This longitudinal study of adolescent girls found high baseline CMV and HSV-1 seroprevalence rates and substantial attack rates for all 3 pathogens.
To examine variables associated with adolescent girls' perceptions of the timing of their first c... more To examine variables associated with adolescent girls' perceptions of the timing of their first consensual intercourse. Methods: One hundred seventy-four primarily African-American adolescent girls, aged 12 to 15 years participated in a 3-year longitudinal study of psychosexual development. Seventy-three percent reported being sexually experienced by the end of the study. They were asked whether they believed their age of initiation was "too young," "too old," or "just right." A generalized estimating equation (GEE) model was used to evaluate predictors of perception of timing of first consensual intercourse. Results: Ninety-nine (78%) said that they were "too young" and 28 (22%) said that their age had been "just right." The results of the final GEE model indicated that variables associated with perceiving age of first consensual intercourse as "just right" included younger chronological age, an older age of first consensual intercourse, endorsement of being "in love" as a reason for first consensual intercourse, greater indirect parental monitoring (vs. "none" or "direct parental monitoring"), and a higher level of education for mothers. Conclusions: Most of these adolescents thought their age of initiation was too young. Factors associated with perceiving the timing of consensual intercourse as "just right" are similar to those reported in the literature to be associated with delaying the initiation of consensual intercourse.
As adolescents develop intimate relationships skills, they might change romantic partners often. ... more As adolescents develop intimate relationships skills, they might change romantic partners often. Little is known about this developmental phenomenon. The goal was to determine the frequency of non-exclusive romantic relationships in girls, the variables associated with non-exclusive relationships, and the variables associated with having sexual intercourse in a non-exclusive relationship. Girls (12-15 years of age) participated in a longitudinal study (3 y, 7 visits) of romantic relationships. Seventy-two of 160 girls had a non-exclusive relationship, and of these, 23 girls had intercourse in an outside relationship. Younger age, belief that the boyfriend had an outside relationship, and less parental indirect monitoring was associated with the girl having an outside relationship. A longer time being sexually experienced and less direct parental monitoring was associated with having intercourse in the outside relationship. Non-exclusivity in adolescence is common but does not always include sexual intercourse. Healthcare providers can address non-exclusivity with adolescents directly.
Adolescent girls could benefit from topical microbicide use if the product is acceptable to them.... more Adolescent girls could benefit from topical microbicide use if the product is acceptable to them. The goal was to evaluate girls', mothers', experienced healthcare providers', and medical students' views on timing of use, efficacy, and safety of topical microbicide use by adolescents. Focus groups were conducted with girls, mothers, healthcare providers, and medical students. All groups were videotaped, transcribed, and coded for relevant themes. A delay between insertion and coitus presented a problem, and pre- and postcoital use had advantages depending on the group. Efficacy was evaluated by timing of use, smell, ability to feel the product, and confidence that it would spread sufficiently. There were concerns about physical side effects and the impact on normal vaginal flora. This study demonstrated the importance of understanding the unique needs and perspectives of adolescent girls and the adults who have an influence on their use.
Purpose: Topical microbicides could be a female-controlled method for prevention of sexually tran... more Purpose: Topical microbicides could be a female-controlled method for prevention of sexually transmitted diseases (STDs). Microbicides could offer girls a potential preventive option, if they are able to access them. The purpose of this investigation was to evaluate girls', mothers', experienced healthcare providers', and medical students' views on adolescent girls' obtaining information about and acquiring microbicides and where adolescent girls would keep or carry a microbicide. Methods: Focus groups were conducted and videotaped with each group of individuals. The videotapes were transcribed, and the transcriptions were coded for relevant themes. Results: Participants anticipated that adolescents would learn about microbicides from a variety of sources and that specific educational efforts for each of these sources (mothers, healthcare providers, and school-based sexuality education) would be needed. Healthcare providers stressed the importance of enhancing access by having both prescription and overthe-counter (OTC) options. For nonprescription products, the participants felt that the microbicide should be in stores and venues to which adolescents typically go by themselves. A microbicide that was girl-friendly and adolescent-friendly consistently was highlighted by the participants. Participants thought this would increase discretion and decrease embarrassment. The location of keeping and carrying the microbicide was anticipated to be dependent on parents' knowledge of their adolescent's sexuality and the likelihood that parents search their adolescent's belongings. Conclusions: Consideration of the adolescent-specific issues in the design of microbicides and marketing strategies may be crucial for adolescent adoption of this female-controlled method.
Journal of Developmental & Behavioral Pediatrics, 2003
Predictors of health-related quality of life (HR-QOL) among inner-city girls and its effect on he... more Predictors of health-related quality of life (HR-QOL) among inner-city girls and its effect on health care use were evaluated. Adolescent girls aged 14 to 18 years (n = 127) completed a demographic and riskbehavior interview, the Kaufman Brief Intellectual Test, and the Medical Outcomes Study Short Form-36. Medical charts were reviewed for health care use. Two assessments were completed 6 months apart. Participants reported stable and poor HR-QOL compared with norms for similar aged females. HR-QOL was associated with some concurrent risk taking. Lower self-perceptions of mental health were associated with inconsistent condom use, smoking, and alcohol use; lower self-perceptions of physical health were associated with pregnancy and smoking. Predictive associations were not found. There was a trend for poorer physical health to be associated with more clinic visits. This study highlights the need for research aimed at both improving self-perceptions of health and decreasing high-risk behavior among inner-city girls.
Background. Cross-sectional seroprevalence studies indicate that infections with herpes simplex v... more Background. Cross-sectional seroprevalence studies indicate that infections with herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2) and cytomegalovirus (CMV) are common. However, data on the rates of acquisition of these infections are limited. Methods. A 3-year longitudinal study of HSV-1, HSV-2, and CMV seroprevalence was conducted in a cohort of 174 adolescent girls (age at enrollment, 12-15 years). Results. At study entry, 41% of the girls reported a history of sexual activity, and by the end of the study, 73% reported a history of sexual activity. At enrollment, 71% of all participants were seropositive for CMV, 44% were seropositive for HSV-1, and 7% were seropositive for HSV-2. By the end of the study, 81% of the girls were seropositive for CMV, 49% were seropositive for HSV-1, and 14% were seropositive for HSV-2. Among girls with a history of sexual activity, 15.5% were HSV-2 seropositive at the beginning of the study, and 18.9% were HSV-2 seropositive at the end of the study. The attack rates, based on the number of cases per 100 person-years, were 13.8 for CMV infection and 3.2 for HSV-1 infection (among all girls) and 4.4 for HSV-2 infection (among girls with a history of sexual activity). Participants with preexisting HSV-1 antibodies were associated with a significantly lower attack rate for HSV-2 infection. A generalized estimating equation model indicated that participants with a longer history of sexual activity and those who had more sexually transmitted diseases during the 6-month periods before the study visits were more likely to be HSV-2 seropositive. Conclusions. This longitudinal study of adolescent girls found high baseline CMV and HSV-1 seroprevalence rates and substantial attack rates for all 3 pathogens.
To examine variables associated with adolescent girls' perceptions of the timing of their first c... more To examine variables associated with adolescent girls' perceptions of the timing of their first consensual intercourse. Methods: One hundred seventy-four primarily African-American adolescent girls, aged 12 to 15 years participated in a 3-year longitudinal study of psychosexual development. Seventy-three percent reported being sexually experienced by the end of the study. They were asked whether they believed their age of initiation was "too young," "too old," or "just right." A generalized estimating equation (GEE) model was used to evaluate predictors of perception of timing of first consensual intercourse. Results: Ninety-nine (78%) said that they were "too young" and 28 (22%) said that their age had been "just right." The results of the final GEE model indicated that variables associated with perceiving age of first consensual intercourse as "just right" included younger chronological age, an older age of first consensual intercourse, endorsement of being "in love" as a reason for first consensual intercourse, greater indirect parental monitoring (vs. "none" or "direct parental monitoring"), and a higher level of education for mothers. Conclusions: Most of these adolescents thought their age of initiation was too young. Factors associated with perceiving the timing of consensual intercourse as "just right" are similar to those reported in the literature to be associated with delaying the initiation of consensual intercourse.
Uploads
Papers by Lisa Mills