Gender differences in sexual risk behaviours and sexually transmissible infections among adolescents in mental health treatment

• Type of Material: Article
• Authors: Puja Seth, Emory University; Delia L Lang, Emory University; Ralph Joseph Diclemente, Emory University; Nikia D. Braxton, Emory University; Richard A. Crosby, University of Kentucky; Larry K. Brown, Rhode Island Hospital; Wendy Hadley, Rhode Island Hospital; Geri R. Donenberg, University of Illinois
• Language: English
• Date: 2012-01-01
• Publisher: CSIRO Publishing
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © CSIRO 2011
• Final Published Version (URL): http://dx.doi.org/10.1071/SH10098
• Title of Journal or Parent Work: Sexual Health
• ISSN: 1448-5028
• Volume: 9
• Issue: 3
• Start Page: 240
• End Page: 246
• Grant/Funding Information: This work also was supported in part by the Center for AIDS Research (P30 AI050409).; Research was supported by NIMH grant MH 63008 to Rhode Island Hospital (P.I. Larry K. Brown, M.D.) and the Lifespan/Tufts/Brown Center for AIDS Research.
• Keywords: Public, Environmental & Occupational Health; Life Sciences & Biomedicine; PREVALENCE; AGES 14; Infectious Diseases; HIV-INFECTION; YOUTH; AMERICAN FEMALE ADOLESCENTS; WOMEN; risky sexual behaviour; Science & Technology; CONDOM USE; UNITED-STATES; COMMUNICATION; PSYCHIATRIC-DISORDERS
• Research Categories: Health Sciences, Public Health; Psychology, Behavioral

Abstract

Background Adolescents with a history of psychiatric disorder(s) are particularly vulnerable to contracting sexually transmissible infections (STIs) as a result of psychological and emotional states associated with higher rates of risky sexual behaviour. The present study examined gender differences in sexual risk behaviours and STI among adolescents in mental health treatment. Methods: Three hundred and seventy nine sexually active adolescents, aged 1318 years, from a larger multisite study, who received mental health treatment during the past year, completed an audio computer-assisted self interview assessing sociodemographics, psychiatric symptomatology and HIV/STI risk behaviours, and provided urine specimens tested for STI. Results: After controlling for covariates, multivariate logistic regression models indicated that female adolescents were more likely to have had an HIV test (adjusted odds ratio (AOR)≤3.2, P≤0.0001), obtain their HIV test results (AOR≤2.9, P≤0.03), refuse sex out of fear for STI acquisition (AOR≤1.7, P≤0.04), or avoid a situation that might lead to sex (AOR≤2.4, P≤0.001), and were less likely to have a casual sex partner (AOR≤0.40, P≤0.002). Additionally, females were more likely to report inconsistent condom use (AOR≤2.60, P≤0.001) and have a STI (AOR≤9.1, P≤0.0001) than their male counterparts. Conclusions: Female adolescents receiving mental health treatment were more than nine times as likely to have an STI and more likely to use condoms inconsistently. The standard of care for mental health practice for adolescents should include referrals for STI screening and treatment as well as assessment and discussion of risky sexual behaviours as part of the treatment plan when indicated. Effective programs should address gender-specific communication and behavioural skills.