Association of depressive symptoms and substance use with risky sexual behavior and sexually transmitted infections among African American female adolescents seeking sexual health care

Jerrold M. Jackson, Puja Seth, Ralph DiClemente, Anne Lin

Research output: Contribution to journalArticle

Abstract

Objectives. We examined how depression and substance use interacted to predict risky sexual behavior and sexually transmitted infections (STIs) among African American female adolescents. Methods. We measured depressive symptoms, substance use, sexual behavior, and STIs in 701 African American female adolescents, aged 14 to 20 years, at baseline and at 6-month intervals for 36 months in Atlanta, Georgia (2005?2007). We used generalized estimating equation models to examine effects over the 36-month follow-up period. Results. At baseline, more than 40% of adolescents reported significant depressive symptoms; 64% also reported substance use in the 90 days before assessment. Depression was associated with recently incarcerated partner involvement, sexual sensation seeking, unprotected sex, and prevalent STIs (all P < .001). In addition, adolescents with depressive symptoms who reported any substance use (i.e., marijuana, alcohol, Ecstasy) were more likely to report incarcerated partner involvement, sexual sensation seeking, unprotected sex, and have an incident STI over the 36-month follow-up (all P < .05). Conclusions. African American female adolescents who reported depressive symptoms and substance use weremore likely to engage in risky behavior and acquire incident STIs. This populationmight benefit from future prevention efforts targeting the intersection of depression and substance use.

Original languageEnglish (US)
Pages (from-to)2137-2142
Number of pages6
JournalAmerican Journal of Public Health
Volume105
Issue number10
DOIs
StatePublished - Jan 1 2015

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Reproductive Health
Sexually Transmitted Diseases
Sexual Behavior
African Americans
Depression
Delivery of Health Care
Unsafe Sex
Sexual Partners
Cannabis
Alcohols

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Association of depressive symptoms and substance use with risky sexual behavior and sexually transmitted infections among African American female adolescents seeking sexual health care",
abstract = "Objectives. We examined how depression and substance use interacted to predict risky sexual behavior and sexually transmitted infections (STIs) among African American female adolescents. Methods. We measured depressive symptoms, substance use, sexual behavior, and STIs in 701 African American female adolescents, aged 14 to 20 years, at baseline and at 6-month intervals for 36 months in Atlanta, Georgia (2005?2007). We used generalized estimating equation models to examine effects over the 36-month follow-up period. Results. At baseline, more than 40{\%} of adolescents reported significant depressive symptoms; 64{\%} also reported substance use in the 90 days before assessment. Depression was associated with recently incarcerated partner involvement, sexual sensation seeking, unprotected sex, and prevalent STIs (all P < .001). In addition, adolescents with depressive symptoms who reported any substance use (i.e., marijuana, alcohol, Ecstasy) were more likely to report incarcerated partner involvement, sexual sensation seeking, unprotected sex, and have an incident STI over the 36-month follow-up (all P < .05). Conclusions. African American female adolescents who reported depressive symptoms and substance use weremore likely to engage in risky behavior and acquire incident STIs. This populationmight benefit from future prevention efforts targeting the intersection of depression and substance use.",
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