A prospective study of psychological distress and sexual risk behavior among black adolescent females.

Ralph DiClemente, G. M. Wingood, R. A. Crosby, C. Sionean, L. K. Brown, B. Rothbaum, E. Zimand, B. K. Cobb, K. Harrington, S. Davies

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: The purpose of the study was to examine the association between adolescents' psychological distress and their sexually transmitted disease/human immunodeficiency virus (STD/HIV)-associated sexual behaviors and attitudes. METHOD: Sexually active black adolescent females (N = 522) completed, at baseline and again 6 months later, a self-administered questionnaire that assessed sexual health attitudes and emotional distress symptoms (using standardized measures, alpha =.84), a structured interview that assessed STD/HIV-associated sexual risk behaviors, and a urine screen for pregnancy. RESULTS: In multivariate analyses, controlling for observed covariates, adolescents with significant distress at baseline were more likely than their peers, after 6 months, to be pregnant (adjusted odds ratio [AOR]: = 2.0), have had unprotected vaginal sex (AOR = 2.1), have nonmonogamous sex partners (AOR = 1.7), and not use any form of contraception (AOR = 1.5). Additionally, they were also more likely to: perceive barriers to condom use (AOR = 2.2), be fearful of the adverse consequences of negotiating condom use (AOR = 2.0), perceive less control in their relationship (AOR = 2.0), have experienced dating violence (AOR = 2.4), feel less efficacious in negotiating condom use with a new sex partner (AOR = 1.6), and have norms nonsupportive of a healthy sexual relationship (AOR = 1.7). DISCUSSION: The findings suggest that psychological distress is predictive over a 6-month period of a spectrum of STD/HIV-associated sexual behaviors and high-risk attitudes. Brief screening to detect distress or depressive symptoms among adolescent females can alert the clinician to the need to conduct a sexual health history, initiate STD/HIV-preventive counseling, and refer for comprehensive psychological assessment and appropriate treatment. Among adolescents receiving STD treatment, those with even moderate emotional distress may be at heightened risk for further unhealthy outcomes. STD/HIV interventions should also consider psychological distress as one potential risk factor that may impact program efficacy.

Original languageEnglish (US)
JournalPediatrics
Volume108
Issue number5
StatePublished - Nov 1 2001

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Risk-Taking
Sexual Behavior
Odds Ratio
Prospective Studies
Psychology
Sexually Transmitted Diseases
HIV
Condoms
Reproductive Health
Negotiating
Attitude to Health
Unsafe Sex
Contraception
Counseling
Multivariate Analysis
Urine
Interviews
Depression
Pregnancy
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

DiClemente, R., Wingood, G. M., Crosby, R. A., Sionean, C., Brown, L. K., Rothbaum, B., ... Davies, S. (2001). A prospective study of psychological distress and sexual risk behavior among black adolescent females. Pediatrics, 108(5).

A prospective study of psychological distress and sexual risk behavior among black adolescent females. / DiClemente, Ralph; Wingood, G. M.; Crosby, R. A.; Sionean, C.; Brown, L. K.; Rothbaum, B.; Zimand, E.; Cobb, B. K.; Harrington, K.; Davies, S.

In: Pediatrics, Vol. 108, No. 5, 01.11.2001.

Research output: Contribution to journalArticle

DiClemente, R, Wingood, GM, Crosby, RA, Sionean, C, Brown, LK, Rothbaum, B, Zimand, E, Cobb, BK, Harrington, K & Davies, S 2001, 'A prospective study of psychological distress and sexual risk behavior among black adolescent females.', Pediatrics, vol. 108, no. 5.
DiClemente R, Wingood GM, Crosby RA, Sionean C, Brown LK, Rothbaum B et al. A prospective study of psychological distress and sexual risk behavior among black adolescent females. Pediatrics. 2001 Nov 1;108(5).
DiClemente, Ralph ; Wingood, G. M. ; Crosby, R. A. ; Sionean, C. ; Brown, L. K. ; Rothbaum, B. ; Zimand, E. ; Cobb, B. K. ; Harrington, K. ; Davies, S. / A prospective study of psychological distress and sexual risk behavior among black adolescent females. In: Pediatrics. 2001 ; Vol. 108, No. 5.
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abstract = "OBJECTIVE: The purpose of the study was to examine the association between adolescents' psychological distress and their sexually transmitted disease/human immunodeficiency virus (STD/HIV)-associated sexual behaviors and attitudes. METHOD: Sexually active black adolescent females (N = 522) completed, at baseline and again 6 months later, a self-administered questionnaire that assessed sexual health attitudes and emotional distress symptoms (using standardized measures, alpha =.84), a structured interview that assessed STD/HIV-associated sexual risk behaviors, and a urine screen for pregnancy. RESULTS: In multivariate analyses, controlling for observed covariates, adolescents with significant distress at baseline were more likely than their peers, after 6 months, to be pregnant (adjusted odds ratio [AOR]: = 2.0), have had unprotected vaginal sex (AOR = 2.1), have nonmonogamous sex partners (AOR = 1.7), and not use any form of contraception (AOR = 1.5). Additionally, they were also more likely to: perceive barriers to condom use (AOR = 2.2), be fearful of the adverse consequences of negotiating condom use (AOR = 2.0), perceive less control in their relationship (AOR = 2.0), have experienced dating violence (AOR = 2.4), feel less efficacious in negotiating condom use with a new sex partner (AOR = 1.6), and have norms nonsupportive of a healthy sexual relationship (AOR = 1.7). DISCUSSION: The findings suggest that psychological distress is predictive over a 6-month period of a spectrum of STD/HIV-associated sexual behaviors and high-risk attitudes. Brief screening to detect distress or depressive symptoms among adolescent females can alert the clinician to the need to conduct a sexual health history, initiate STD/HIV-preventive counseling, and refer for comprehensive psychological assessment and appropriate treatment. Among adolescents receiving STD treatment, those with even moderate emotional distress may be at heightened risk for further unhealthy outcomes. STD/HIV interventions should also consider psychological distress as one potential risk factor that may impact program efficacy.",
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