Predicting sexual risk behaviors among adolescent and young women using a prospective diary method

Abstract

We describe the sexual risk behaviors, psychological distress, and substance use of 102 late adolescent girls and identify predictors of protected and unprotected vaginal sex. Participants completed questionnaires assessing hypothesized predictors and then daily behavioral diaries for 12 weeks. Protected intercourse was predicted by baseline sexual behavior, greater knowledge, positive condom attitudes, lower perceived condom-use difficulty, greater condom-use intentions, more drinking days, less binge drinking, less Ecstasy use, and lower psychological distress. Unprotected intercourse was predicted by baseline sexual behavior, binge drinking, Ecstasy and opiate use, fewer drinking days, and fewer daily drinks. These findings suggest that psychological distress, substance use, and sexual risk behavior are interconnected and should be considered collectively in interventions for adolescent females. Publisher's Disclaimer: This PDF receipt will only be used as the basis for generating PubMed Central (PMC) documents. PMC documents will be made available for review after conversion (approx. 2-3 weeks time). Any corrections that need to be made will be done at that time. No materials will be released to PMC without the approval of an author. Only the PMC documents will appear on PubMed Central --this PDF Receipt will not appear on PubMed Central. (2006) examined the relationship between patterns of risk behaviors (i.e., smoking, sex, drug, and alcohol use) and depressive symptoms. Overall, girls experienced more depressive symptoms than boys, and every risk behavior was related to increased depressive symptoms. Although their study was limited by its cross-sectional design, it provides evidence of the prominent nature of depressive symptoms in a nationally representative sample of adolescent girls. Keywords NIH Public AccessThe clustering of sexual and substance use behaviors was also observed in a recent study of clients attending an STD clinic (50% female); in this sample of patients with documented sexual risk behaviors, one-third of the females were also classified as having a substance use disorder (Cook et al., 2006). Other investigators have reported a significant association between substance use and risky sex in teens as young as 12-15 years (Bachanas et al., 2002). The co-occurrence of substance use and risky sex has not been found universally, however; for example, drinking before sex was not related to unprotected sex in girls attending an STD clinic (Fortenberry, Orr, Katz, Brizendine, & Blythe, 1997) nor in college students (deVisser & Smith, 2001).In summary, psychological distress and depressive symptoms, substance use, and sexual health are often intertwined in girls from early to late adolescence and their interconnectedness needs to be clarified. To reduce the incidence of HIV in adolescent girls, health educators and other interventionists must develop effective, theoretically-driven gender-tailored interventions that target the determinants of sexual risk behavior (Fishbein, 2000). NIH...

Clustering of Sex and Substance Use Behaviors in Adolescence

“…Several studies have linked substance use, both licit and illicit, with sexual activity among teens (Bachanas et al, 2002;Connell, Gilreath, & Hanson, 2009;Lowry et al, 1994;Morrison-Beedy, Carey, Feng, & Tu, 2008). For example, in the United States an increased risk of violence and sexual risk behavior was found among late adolescents/young adults who reported use of alcohol and illicit drugs (Baskin-Sommers & Sommers, 2006).…”

Risky sexual behavior and substance use among adolescents: A meta-analysis

“…The measure of SU is not restricted to sexual situations. In this case, an individual’s global SU across all situations is considered (see Morrison-Beedy, Carey, Feng, & Tu, 2008). Situational measures, on the other hand, specifically assess the extent to which SU and RSB have occurred during a specific range of time or set of sexual encounters.…”

Sex, drugs and STDs: Preliminary findings from the Belfast Youth Development Study

“…Consistent with previous research (Bachanas et al, 2002;Lowry et al, 1994;Morrison-Beedy et al, 2008) sexual activity and sexual risk Notes: (0) indicates the reference condition entered into the regression; Daily ecstasy and daily cocaine use was not reported by any participant and was therefore not included in the regression model; r ¼ regression co-efficient. *p 5 0.05; **p 5 0.01; ***p 5 0.001.…”

“…Young people's participation in risky sexual behaviours has been linked to a range of other such risky behaviours, but in particular with the use of licit and illicit substances. In particular the use of alcohol, cannabis and ecstasy have all been linked to increased participation in risky sexual behaviours and subsequently to increased risk to health through transmission of STDs (Bachanas et al, 2002;Lowry et al, 1994;Morrison-Beedy, Carey, Feng, & Tu, 2008;Valois, Oeltmann, Waller, & Hussey, 1999).…”