PMID- 29608615
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20190329
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 4
DP  - 2018
TI  - Executive function associated with sexual risk in young South African women:
      Findings from the HPTN 068 cohort.
PG  - e0195217
LID - 10.1371/journal.pone.0195217 [doi]
AB  - PURPOSE: Heightened sexual risk in adolescence and young adulthood may be
      partially explained by deficits in executive functioning, the set of cognitive
      processes used to make reasoned decisions. However, the association between
      executive function and sexual risk is understudied among adolescent girls and
      young women, particularly in low- and middle-income countries. METHODS: In a
      cohort of 853 young women age 18-25 in rural Mpumalanga province, South Africa,
      we evaluated executive function with three non-verbal cognitive tests: I. a
      rule-finding test, II. a trail-making test, and III. a figure drawing test. Using
      log-binomial regression models, we estimated the association between lower
      executive function test scores and indicators of sexual risk (unprotected sex
      acts, concurrent partnerships, transactional sex, and recent HSV-2 infection).
      RESULTS: In general, young women with lower executive function scores reported
      higher frequencies of sexual risk outcomes, though associations tended to be
      small with wide confidence intervals. Testing in the lowest quintile of Test I
      was associated with more unprotected sex [aPR (95% CI): 1.4 (1.0, 1.8)]. Testing 
      in the lowest quintile of Test II was associated with more concurrent
      relationships and transactional sex [aPR (95% CI): 1.6 (1.1, 2.5) and 1.7 (1.3,
      2.4), respectively], and testing in the lowest four quintiles of Test III was
      associated with more concurrent relationships [aPR (95% CI): 1.7 (1.0, 2.7)].
      CONCLUSIONS: These results demonstrate an association between low executive
      function and sexual risk in South African young women. Future work should seek to
      understand the nature of this association and whether there is promise in
      developing interventions to enhance executive function to reduce sexual risk.
FAU - Rosenberg, Molly
AU  - Rosenberg M
AUID- ORCID: 0000-0001-6679-6791
AD  - Department of Epidemiology and Biostatistics, Indiana University School of Public
      Health-Bloomington, Bloomington, IN, United States of America.
FAU - Pettifor, Audrey
AU  - Pettifor A
AD  - Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel
      Hill, NC, United States of America.
AD  - Carolina Population Center, University of North Carolina-Chapel Hill, Chapel
      Hill, NC, United States of America.
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt),
      School of Public Health, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
FAU - Duta, Mihaela
AU  - Duta M
AD  - Department of Experimental Psychology, University of Oxford, Oxford, United
      Kingdom.
FAU - Demeyere, Nele
AU  - Demeyere N
AD  - Department of Experimental Psychology, University of Oxford, Oxford, United
      Kingdom.
FAU - Wagner, Ryan G
AU  - Wagner RG
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt),
      School of Public Health, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - INDEPTH Network, Accra, Ghana.
AD  - Umea Centre for Global Health Research, Division of Epidemiology and Global
      Health, Department of Public Health and Clinical Medicine, Umea University, Umea,
      Sweden.
FAU - Selin, Amanda
AU  - Selin A
AD  - Carolina Population Center, University of North Carolina-Chapel Hill, Chapel
      Hill, NC, United States of America.
FAU - MacPhail, Catherine
AU  - MacPhail C
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt),
      School of Public Health, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - School of Health and Society, University of Wollongong, Wollongong, New South
      Wales, Australia.
AD  - Wits Reproductive Health and HIV Institute, University of the Witwatersrand,
      Johannesburg, South Africa.
FAU - Laeyendecker, Oliver
AU  - Laeyendecker O
AD  - Laboratory of Immunoregulation, NIAID, NIH, Baltimore, MD, United States of
      America.
AD  - Department of Medicine, Johns Hopkins University, Baltimore, MD, United States of
      America.
FAU - Hughes, James P
AU  - Hughes JP
AD  - Department of Biostatistics, University of Washington, Seattle, WA, United States
      of America.
FAU - Stein, Alan
AU  - Stein A
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt),
      School of Public Health, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
FAU - Tollman, Stephen
AU  - Tollman S
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt),
      School of Public Health, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - INDEPTH Network, Accra, Ghana.
AD  - Umea Centre for Global Health Research, Division of Epidemiology and Global
      Health, Department of Public Health and Clinical Medicine, Umea University, Umea,
      Sweden.
FAU - Kahn, Kathleen
AU  - Kahn K
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt),
      School of Public Health, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - INDEPTH Network, Accra, Ghana.
AD  - Umea Centre for Global Health Research, Division of Epidemiology and Global
      Health, Department of Public Health and Clinical Medicine, Umea University, Umea,
      Sweden.
LA  - eng
GR  - UM1AI068617 /NH/NIH HHS/United States
GR  - UM1AI068613 /NH/NIH HHS/United States
GR  - UM1AI068619 /NH/NIH HHS/United States
GR  - UM1 AI068613/AI/NIAID NIH HHS/United States
GR  - R24 HD050924 /NH/NIH HHS/United States
GR  - P2C HD050924/HD/NICHD NIH HHS/United States
GR  - 5R01MH087118-02 /NH/NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20180402
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *African Continental Ancestry Group
MH  - Age Factors
MH  - *Executive Function
MH  - Female
MH  - Herpes Genitalis
MH  - Humans
MH  - Mass Screening
MH  - Public Health Surveillance
MH  - Rural Population
MH  - Sex Factors
MH  - *Sexual Behavior
MH  - Socioeconomic Factors
MH  - South Africa/epidemiology
MH  - Unsafe Sex
MH  - Young Adult
PMC - PMC5880379
EDAT- 2018/04/03 06:00
MHDA- 2018/07/17 06:00
CRDT- 2018/04/03 06:00
PHST- 2017/03/22 00:00 [received]
PHST- 2018/03/05 00:00 [accepted]
PHST- 2018/04/03 06:00 [entrez]
PHST- 2018/04/03 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
AID - 10.1371/journal.pone.0195217 [doi]
AID - PONE-D-17-11319 [pii]
PST - epublish
SO  - PLoS One. 2018 Apr 2;13(4):e0195217. doi: 10.1371/journal.pone.0195217.
      eCollection 2018.