The Wellbeing of Adolescents in
Vulnerable Environments:
a five-city study of slum dwelling youth
Background
Young Health Programme: designed to help young
people in need around the world deal with the health
issues they face so they can improve their chances of
living a better life
• Includes work on the ground, research and advocacy
• Partnership
2
WAVE : Study Aims
• Describe the health challenges of teens in very
vulnerable communities within 5 cities:
Baltimore
Ibadan
New Delhi
Johannesburg
Shanghai
• Examine factors influencing health, including physical
and social environment,
• Compare results across sites
3
Collaborating Organizations
• Shanghai Institute of Planned Parenthood Research
(China)
• Wits Reproductive Health and HIV Institute (South Africa)
• Population Council (India)
• Center for Population and Reproductive Health,
University College Hospital (Nigeria)
• Department of Population, Family and Reproductive
Health, Johns Hopkins
4
Target Population
• Youth ages 15-19 in very low-income urban
neighborhoods:
– youth in and out of school
– youth in households and unstably housed/
homeless
– Shanghai site: only included migrant youth
5
Well-being
Capital
Hygiene
Physical
Substance Use
Human
Roadmaps to
Realistic
Aspirations
Physical Safety
Agency
Opportunities
Financial
Nutrition
Social
Mental Health
Cultural
Sexual and
Reproductive
Health
Sense of Civic
Responsibility
Phases of the Study
Phase 1: Qualitative examination of the
perspectives of youth and
knowledgeable adults
Field Period: 2011-2012
Phase 2: Respondent Driven Sample Survey
to test results and themes emerging
from the qualitative phase
Field Period 2013
7
Phase #1: Data Collection at Each Site:
Collecting Data about Adolescents
• Walking and mapping the area
• Conducting approximately 20 key
informant interviews with providers
and directors of youth servicing
organizations
Phase #1: Data Collection at Each Site:
Collecting Data with Adolescents
• Photovoice to document health issues (n=10)
• Community mapping activity to document
perspectives of resources in community (8
groups)
• Focus groups to identify shared views of needs
and resources (8 groups)
• In-depth interviews to obtain their personal
perspectives and experiences (n=20)
Qualitative Findings
Kristin Mmari
Cross-site Analysis
Baltimore, Shanghai, Johannesburg, Delhi, & Ibadan:
 All interviews were recorded, transcribed, and
translated
 Transcripts were imported into Atlas.TI
(version 7) for analysis
 Initial code list tested across sites, feedback
was incorporated into final code list
 After coding was completed, HUs were sent
to Baltimore
 Matrices of themes were developed to
analyze for patterns across sites
Key Phase #1 Findings
Kristin Mmari
What Are the Top Health Concerns
among Adolescents?
Across sites, there was a general consensus:
 For adolescent girls: sexual and reproductive
health problems are prominent
 For adolescent boys: tobacco, drug and alcohol
consumption was a huge problem, which further
led to violence
 In Shanghai, smoking was the biggest problem among
boys; whereas in the other sites, drugs and alcohol
were more prevalent
Selected Quotes about Sexual and
Reproductive Health
 “Oh my gosh, at my school, half of the girls in my school
are pregnant or already have a baby or about to have
another one. Everybody is pregnant” (IDI, Baltimore
female adolescent)”
 “A lot of the girls suffer from gynecology related health
problems. In fact, my menstruation is not normal…Now, a
lot of women have uterine fibroids and people will die of
this disease.” (IDI, Shanghai female adolescent)
Selected Quotes about
Drugs and Violence
 “You see alcohol everywhere. When you go by the corner,
there is a tavern, and when you turn, there is a tavern.
When you turn around, there is someone selling dagga
(marijuana) and you would think they are selling sweets
and samba chips.” (IDI Johannesburg male adolescent,)
 “Here, young people consume too much of intoxicants.
There is one child of 8-9 years old and he smokes cigarettes
and eats Gutkha because he stays with big youngsters, and
his parents don’t pay any attention to him.. Here, there are
many children of that kind here.” (Key informant interview,
Delhi)
Perception of Safety
Particularly in Baltimore, Johannesburg, and Delhi
– In Baltimore and Johannesburg, adolescents didn’t feel safe
even in their homes
What would you say are your most pressing problems? (Interviewer)
I think being in Hillbrow, because I don’t feel safe anymore (adolescent)
What makes you feel not safe? (Interviewer)
The thing is that where we stay you will hear a person screaming from
being beaten up in the middle of the night and there are also break-ins
(adolescent)
The Physical Environment
Compromises Health at all Sites
All these neighborhoods, all these alleys. Some
have all these big rats going around in people’s
trash. It’s nasty. Then, there’s the vacant houses,
and you’ve got houses that are right next to these
vacant homes. And, so what is the health
department doing? Nothing. And, then, there’s
people staying in these vacant houses.. And, then
you’ve got drug needles on the ground.
(IDI, Baltimore male adolescent)
In order to have an healthy community you have to have neighbors who
are willing to do something about it.
By: Brittany McAdams
People living around this very dirty environment may contact diseases and they can’t have good, clean fresh air
to breath.
Wale Adeshina (18) Ibadan
The Social Environment
Matters for Health
 In Baltimore and Johannesburg, the social
environment was limited and characterized as
adolescents growing up without parents or
parental/adult guidance
 In Shanghai, it depended on the type of
migrant group
 In Delhi and Ibadan, it depended more on
gender
Broken Families and Lack of
Guidance are Common
In Baltimore and Johannesburg (Hillbrow): it is common for
adolescents to live without one or more both parents
raising themselves:
A lot of the parents is out here on drugs. So, the kids are
being raised by themselves. Foster kid system is worse,
because they [foster parents] are just in it for the money.
They don’t help. And the social workers – they just give up
on the kids, because the kids don’t care, like they have
nothing to live for. That’s because their parents had ruined
their lives, and their parents’ parents ruined their lives, so
it’s a big cycle going on, and it’s like: who are we to blame?
(IDI, Baltimore female adolescent)
In Shanghai: Type of Migrant Matters
Street vendor children live in poorer communities, are most
vulnerable are most likely to experience discrimination by
local residents:
The Shanghainese parents are most different from
these migrants.’ They watch their children relatively
tighter. Because of the bad conditions of the
migrant population, the parents leave home very
early for work, so many of the migrant children end
up doing a lot of the household work themselves.
(Key informant, Shanghai)
New Delhi and Ibadan:
Females were “Overprotected”
and Restricted to Homes
 In New Delhi: parents want to prepare girls for
marriage:
“The boys get full freedom and they can go anywhere – they can
roam and do anything they desire. But the girls can’t be given
this full freedom, because if anything were to happen to them, it
would defame the family…” (Key informant, Delhi)
 In Ibadan, girls are just perceived to be weaker
and needing more protection:
“To be a boy in Yemetu, you know, a boy can go anywhere,
where they like at Yemetu, but girls have some particular places
they must not go to. So girls are not really free at Yemetu
because of guys”.(Male adolescent)
Linking Environments to Health:
Baltimore and Johannesburg
Girls – unsafe sexual behaviors and outcomes
• Physical environment: the lack of recreation facilities & vacant
housing
• Social environment: lack of positive adult relationships and
general mistrust of adults
• Health services: Lack of trust echoed in mistrust of health care
providers
Boys – drugs and violence
• Physical environment: garbage & vacant homes
• Social environment: lack of positive adult relationships, sibling
behaviors; peers
• Health services: mistrust and perception that one is ‘weak’
Linkages….
New Delhi and Ibadan:
– Overall – better sense of health
– Girls’ restriction and lack of safety contributed to
embarrassment/shyness for seeking care
– Boys’ drug and alcohol use discussed more in relation to the physical
environment (dirtiness and presence of liquor shops)
Shanghai:
– Similar to New Delhi and Ibadan – better sense of health
– Type of migrant seemed to matter
– Boy’s smoking was one of the most discussed health problems – to
relieve pressure
Phase 2 RDS Methodology
and Social Capital
Preliminary Findings
Beth Marshall
Methods
Respondent Driven Sampling
• Chain referral method for hidden populations for
which no sampling frame exists
• Primarily used for high-risk groups
RDS advantages over other chain referral method
• Controlled recruitment
• Records information about respondents’ networks
27
Implementation
Procedures informed by qualitative phase
– Readiness of youth to recruit their peers
– Relevant characteristics for seeds
– Where to conduct data collection
Recruitment starts with seeds, selected nonrandomly, each seed can recruit up to 3 recruits,
facilitated by a coupon
28
Seeds: Baltimore
ID
Gender
Age
Race
School
Zip code
1
M
15
AA
In school
21213
2
M
18
AA
Graduate 21202
7
M
15
AA
In School
70
F
18
AA
Graduate 21224
78
F
18
AA
In School
144
F
17
AA
Graduate 21205
537
M
15
H
In School
21205
21202
21231
Example of recruitment chain: Baltimore
30
Did We Reach Youth that are Missed in
Household and School-based Methods?
70
Baltimore
60
Delhi
50
Ibadan
40
Shanghai
30
Johannesburg
20
10
0
Unstably housed
Age 16, out of school
Chronic school absenteeism
31
Social Capital and Adolescents
• Compare and contrast levels of social capital
across these domains in five diverse urban
settings
• Examine group membership associations with
self report measures of social capital
Family Social Capital by Gender
12
10.1
10
8.8
8
9
8.6 8.5
7.1
7.5
9.2
8.6
8.5
8.1
7.8
7.3
7.6
6.8
6.7
7.7 7.6
6.6 6.7
6
4
2
0
BALTIMORE
DELHI
Caring Adult Female
IBADAN
J'BURG
Caring Adult Male
SHANGHAI
School Social Capital by Gender
18
16
14
13.4
12.3
12
12.3
11.4 11.4
11.2
10
8
6
4
2
0
0
BALTIMORE
DELHI
0
IBADAN
0
J'BURG
0
SHANGHAI
Social Capital – Quality Peers by Gender
18
16
15.1
14.9 14.7
13.6 13.6
14
13.2
13.8
14.9
15.2
13.1
12
10
8
6
4
2
0
BALTIMORE
DELHI
IBADAN
J'BURG
SHANGHAI
40
Social Capital – Peer Density by Gender
35.3
35
32.6
30
25
20
14.5
15
13.8
13.5
11.2
10.3 10.2
10
6.9 6.9
5
0
2.6
3.5
12.8
6.4
3.5 3.5
3.2 3.3
1.5 1.6
10.2
7
5.3 5.2
4.5 4.8
2 2
1.9 1.7
0
0
1
2
Baltimore
3
Delhi
4
Ibadan
5
J’Burg
6
Shanghai
Neighborhood Social Capital –
Community Cohesion and Connection
to Neighborhood by Gender
9
8
7.4
7
7
6.9
6.3
6
5.6
5.9
5.9
7.1
6.1
6
6.3
5.4
5.3 5.4
5.2
5
4.7
4.4
3.8
4
4
3.8
3
2
1
0
0
0
1
2
Baltimore
3
Delhi
4
Ibadan
5
J’Burg
6
Shanghai
Associations of Social Capital
and School Enrollment
BALTIMORE
β (CI)
DELHI
β (CI)
IBADAN
β (CI)
J'BURG
β (CI)
SHANGHAI
β (CI)
500
449
496
438
0.08(-.83, 0.98)
0.53(-1.05, 2.10)
-0.39(-1.05, 0.27)
0.66**(0.22,1.11)
2.89**(1.5,4.27)
0.21(-0.55,0.96)
0.70(-0.74, 2.15)
-0.33(-1.29,0.62)
0.88**(0.28,1.47)
2.63***(1.97,3.3)
-0.26(-0.89,0.35)
0.83(-0.34,1.99)
Quality Peers
.07(-0.71,0.84)
-0.23(-1.52,1.05)
Density Peers
0.43(-1.07,1.92)
0.53 (-0.10,1.15) -0.64*(-1.28,-0.003) 0.11(-0.47,0.70)
N
456
School Enrollment (reference is not enrolled)
FAMILY
Caring Adult Female
Caring Adult Male
SCHOOL
Caring Adults in School
1.06**(0.39,1.72)
PEERS
-0.27(-1.32,0.78)
-0.41(-1.23,0.41)
0.84*(0.009,1.68)
-0.009(-0.59,0.57)
NEIGHBORHOOD
Community Cohesion
1.04***(0.44,1.63) 0.42***(0.22,0.62)
0.17(-0.38,0.72)
-0.07(-0.45,0.31)
0.16(-0.26,0.26)
Connection to Neighborhood
0.81*(0.10,1.51)
0.09(-0.48,0.67)
-0.48 (-0.99,0.03)
0.45*(0.15,0.74)
0.40(-0.39,1.19)
Associations of Social Capital and Family
BALTIMORE
β (CI)
N
456
DELHI
β (CI)
500
IBADAN
β (CI)
449
J'BURG
β (CI)
496
SHANGHAI
β (CI)
438
Family Structure – Raised by One Parent (reference is two parents)
FAMILY
Caring Adult Female
Caring Adult Male
-0.26(-1.36, 0.84)
0.69(-0.73, 2.12)
-2.74***(-3.31,-2.18) -0.16(-1.31,0.98)
- 0.74(-2.19, 0.72) -0.29(-0.83,0.25)
-0.01(-0.49,0.46)
-0.71(-1.70,0.27) -1.29*(-2.41,0.16)
-2.34***(-2.65,-2.02)
SCHOOL
Caring Adults in School
PEERS
-0.19(-1.10,0.71)
Quality Peers
-1.24**(-2.17,-0.31) 2.2***(1.44,3.02)
-0.12(-1.48,1.23)
-0.22(-0.61,0.17)
Density Peers
-0.13(-1.45,1.19)
0.42(-1.23,2.07)
0.20(-0.51,0.91)
0.08(-0.55,0.71)
-1.15***(-1.28,-1.03)
-0.003(-1.76,1.75)
-0.33(-1.57,0.92)
-1.15***(-1.74,-0.56)
-0.24(-0.82,0.34)
-0.31(-1.44,0.81)
-1.18(-2.67,0.31) -0.45 (-0.95,0.06)
1.99*(0.99,3.00)
-1.30*(-2.34,-0.26)
1.82***1.72,1.94)
NEIGHBORHOOD
Community Cohesion
Connection to Neighborhood
-1.51***(-1.82,-1.21)
-0.21(-1.07,0.66)
-1.52***(-2.0,-1.02)
Associations of Social Capital and Family
BALTIMORE
β (CI)
DELHI
β (CI)
IBADAN
β (CI)
J'BURG
β (CI)
500
449
N
456
496
Family Structure – Raised by Other Relatives on Non-relatives (reference is two parents)
SHANGHAI
β (CI)
438
FAMILY
Caring Adult Female
Caring Adult Male
-1.31***(-1.90,-0.72) -1.51**(-2.22,-0.81) -0.95*(-1.85,-0.05)
-1.0***(-1.35,-0.67) -1.15*(-1.85,-0.4)
-2.39***(-3.31,-1.48) -1.55*(-2.64,-0.45)
-0.64*(-1.21,0.06)
-0.71(-1.70,0.27)
-1.49***(-1.87,-1.11)
SCHOOL
Caring Adults in School
PEERS
Quality Peers
Density Peers
-0.33(-0.75,0.10)
1.07*(0.16,1.97)
-0.41(-1.0,0.17)
-0.64**(-1.19,-0.87)
-0.11(-0.33,0.11)
-0.36(-1.51, 0.79)
-0.19(-0.52,0.15)
-0.18(-0.47,0.10)
-0.73(-1.82,0.36)
-0.44 (-0.95,0.7)
-0.15(-0.63,0.32)
-0.11(-0.49,0.28)
-0.21(-0.92,0.50)
-2.15***(-2.89,-1.40) 0.78*(0.09,1.47)
2.27***(1.00,3.54)
0.16(-0.51,0.84)
NEIGHBORHOOD
Community Cohesion
-0.41*(-0.79,-0.03)
Connection to Neighborhood -.88***(-1.19,-0.57) -0.74*(-1.32,-0.16)
-0.14(-0.56,0.28)
-0.42**(-0.70,-0.14)
-0.21(-0.64,-0.26)
Gender Based Violence
Sarah Peitzmeier
Gender-based Violence
• Describe prevalence and correlates of
intimate partner violence and nonpartner sexual assault,
• Evaluate associations with key health
outcomes across domains of substance
use, sexual and reproductive health, and
mental health among young females
Prevalence of GBV
Baltimore
(n=173)
Delhi
(n=30)
Ibadan
(n=60)
Physical IPV, past year
24.3%
16.6%
25.9%
30.9%
8.8%
Sexual IPV, past year
10.6%
7.2%
14.7%
18.3%
1.8%
Any IPV, past year
27.7%
19.4%
32.8%
36.6%
10.2%
(n= 189)
(n=250)
(n=218)
(n=224)
(n=220)
6.2%
1.6%
5.1%
9.1%
1.0%
12.3%
1.9%
8.2%
12.6%
1.2%
Non-partner sexual
violence, past year
Non-partner sexual
violence, ever
Johannesburg Shanghai
(n=200)
(n=142)
Health and IPV in Johannesburg
IPV-exposed
IPV-unexposed
70%
63%
60%
47%
50%
40%
38%
37%
33%
31%
30%
22%
20%
10%
13%
17%
6%
0%
Past-month binge
drinking
AOR=7.7
(4.4, 13.5)
Multiple sex
partners, past
year
AOR=6.0
(3.4, 10.6)
Ever pregnant
AOR=1.7
(1.0, 2.8)
Condom non-use
Positive
at last sex
depression screen
(CES-D)
AOR=4.5
(2.2, 9.3)
AOR=3.1
(2.1, 4.4)
Health and IPV in Baltimore
IPV-exposed
IPV-unexposed
60%
50%
50%
44%
41%
39%
40%
33%
29%
30%
19%
20%
11%
14%
10%
10%
0%
Past-month binge
drinking
AOR=0.6
(0.2, 1.9)
Multiple sex partners,
past year
AOR=3.0
(2.0, 4.6)
Anal intercourse, ever Condom non-use at last
sex
AOR=2.8
(1.4, 5.7)
AOR=1.3
(0.6, 2.9)
Positive depression
screen (CES-D)
AOR=1.8
(1.0, 3.4)
Health and SA in Johannesburg
IPV-exposed
IPV-unexposed
60%
54%
50%
45%
44%
43%
41%
40%
30%
25%
26%
22%
20%
16%
16%
10%
0%
Past-month binge
drinking
AOR=1.7
(0.7, 4.1)
Multiple sex partners,
past year
AOR=4.4
(2.5, 7.5)
Ever pregnant
AOR=0.9
(0.5, 1.5)
Condom non-use at last
sex
AOR=2.8
(1.1, 7.0)
Positive depression
screen (CES-D)
AOR=1.8
(1.1, 3.0)
Health and SA in Baltimore
IPV-exposed
IPV-unexposed
100%
89%
90%
80%
70%
60%
50%
50%
42%
40%
29%
30%
20%
10%
20%
41%
26%
25%
10%
9%
0%
Past-month binge
drinking
Multiple sex partners,
past year
AOR=1.9
(0.4, 9.8)
AOR=0.8
(0.2, 3.1)
Anal intercourse, ever Condom non-use at last
sex
AOR=6.2
(2.6, 14.9)
AOR=1.2
(0.7, 2.1)
Positive depression
screen (CES-D)
AOR=55.0
(32.3, 93.7)
Adolescent Pregnancy
Anna Kaagesten
Goals
To describe the prevalence of teenage pregnancy
and associated outcomes among heterosexually
experienced females and males;
To assess the demographic, behavioral and
neighborhood-level factors associated with
teenage pregnancy among females and males
Prevalence of Pregnancy and
Reproductive History: Females
B’MORE
N=193
JO’BURG
N=224
IBADAN
N=229
SHANGHAI
N=216
DELHI
N=250
W% (n/N)
W% (n/N)
W% (n/N)
W% (n/N)
W% (n/N)
75.3%
(130/193)
55.5%
(130/224)
16.0%
(31/229)
8.4%
(19/216)
0.3%
(3/250)
52.9%
(53/130)
28.8%
(25/130)
24.1%
(7/31)
16.1%
(3/19)
52.2%
(1/3)
14.4%
(9/53)
31.6%
(14/25)
36.0%
(3/7)
84.0%
(2/3)
100.0%
(1/1)
EVER ABORTION
31.9%
(23/53)
14.6%
(7/25)
54.5%
(4/7)
16.0%
(1/3)
100.0%
(1/1)
EVER GAVE BIRTH
56.1%
(23/53)
32.5%
(12/25)
38.4%
(2/7)
--
--
1
94.0%
(19/23)
99.4%
(11/12)
52.7%
(1/2)
--
--
2 or more
6.0%
(4/23)
0.6%
(1/12)
47.3%
(1/2)
--
--
EVER SEXUAL INTERCOURSE
EVER PREGNANT
CURRENTLY PREGNANT
NUMBER CHILDREN GAVE BIRTH TO
Prevalence of Pregnancy and
Reproductive History: Males
B’MORE
N=263
JO’BURG
N=272
IBADAN
N=220
SHANGHAI
N=222
DELHI
N=250
W% (n/N)
W% (n/N)
W% (n/N)
W% (n/N)
W% (n/N)
EVER SEXUAL INTERCOURSE
86.4%(
222/263)
69.2%
(216/272)
44.0%
(86/220)
25.5%
(78/222)
16.7%
(39/250)
PARTNER EVER PREGNANT
24.9%
(63/222)
22.2%
(57/216)
17.6%
(11/86)
10.7%
(15/78)
15.4%
(6/39)
PARTNER EVER ABORTION
65.7%
(35/63)
45.2%
(29/57)
62.3%
(8/11)
51.4%
(9/15)
9.3%
(3/6)
PARTNER EVER GAVE BIRTH
46.0%
(23/63)
32.8%
(20/57)
72.2%
(7/11)
--
3.6%
(1/6)
1
77.2%
(16/23)
91.3%
(16/20)
5.6%
(1/7)
--
100.0%
(1/1)
2 or more
22.8%
(7/23)
8.7%
(4/20)
94.5%
(6/7)
--
--
NUMBER OF CHILDREN
Adjusted Association with
Pregnancy: Females
BALTIMORE FEMALES
JOHANNESBURG FEMALES
AOR (95% CI)
AOR (95% CI)
AGE (CONT.)
1.3* (0.61, 2.63 )
1.2 (0.70, 1.93 )
CURRENTLY IN SCHOOL (REF: NOT)
0.2* (0.04, 0.80)
0.1* (0.004, 0.82)
RAISED BY ONE PARENT (REF: TWO PARENTS)
--
18.4*** (12.6, 26.9)
RAISED BY OTHER ADULTS (REF: TWO PARENTS)
--
4.5* (1.5, 3.7)
UNSTABLE HOUSING (REF: STABLE)
5.1* (1.7, 15.5)
1.6 (0.7, 3.6)
BINGE DRINKING LAST MONTH (REF: NO DRINK)
3.9* (1.2, 12.6)
--
--
7.5** (3.3, 16.4)
EVER TRANSACTIONAL SEX (REF: NEVER)
EVER SAME-SEX PARTNER (REF: NEVER)
0.2** (0.06, 0.5)
0.2* (0.1, 0.9)
4.2 (0.8, 20.8)
0.4* (0.2, 0.7)
ANY BIRTH CONTROL FIRST SEX (REF: NO)
--
0.1*** (0.05, 0.2)
0.1** (0.03, 0.3)
--
ALWAYS USED CONDOMS PAST YEAR (REF: NOT)
--
0.3 (0.06, 2.0)
PERCEIVED FEAR (SCALE)
--
1.1** (1.0, 1.1)
COMMUNITY VIOLENCE (SCALE)
--
1.3*** (1.2, 1.4)
1.0 (0.9, 1.1)
0.9** (0.8, 0.9)
SEXUAL DEBUT < AGE 15 (REF: >=15)
CONDOM FIRST SEX (REF: NOT)
PHYSICAL ENVIRONMENT (SCALE)
*p<.05, **p<.01, ***p<.001
Adjusted Associations with
Pregnancy: Males
BALTIMORE MALES
AOR (95% CI)
JOHANNESBURG MALES
AGE (CONT.)
1.1 (0.8, 1.5)
1.5** (1.2, 1.8)
CURRENTLY IN SCHOOL (REF: NOT)
0.7 (0.4, 1.5)
0.4*** (0.4, 0.4)
6.4*** (3.2, 12.7)
--
0.1 (0.01, 2.3)
--
6.7*** (2.4, 18.8)
0.8 (0.5, 1.2)
1.1 (0.3, 4.0)
5.4*** (4.3, 6.7)
--
1.7* (1.1, 2.7)
SAME WEALTH AS MOST (REF: POORER)
WORSE WEALTH THAN MOST (REF: POORER)
BINGE DRINKING LAST MONTH (REF: NO DRINK)
SEXUAL DEBUT < AGE 15 (REF: >=15)
EVER TRANSACTIONAL SEX (REF: NEVER)
CONDOM FIRST SEX (REF: NOT)
ALWAYS USED CONDOMS PAST YEAR (REF: NOT)
FEEL UNSAFE IN COMMUNITY (REF: SAFE)
PERCEIVED FEAR (SCALE)
COMMUNITY VIOLENCE (SCALE)
PHYSICAL ENVIRONMENT (SCALE)
*p<.05, **p<.01, ***p<.001
AOR (95% CI)
0.5 (0.05, 4.6)
--
1.3 (0.9, 1.88)
0.2** (0.1, 0.4)
--
1.3***
0.9***
1.1*
--
--
0.9***