Risky Sexual Behavior in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

• Authors: James Klosky, Emory University; Rebecca H. Foster, Winona State University; Zhenghong Li, Emory University; Courtney Peasant, St. Jude Children’s Research Hospital; Carrie Howell, St. Jude Children’s Research Hospital; Ann Mertens, Emory University; Leslie L. Robison, St. Jude Children’s Research Hospital; Kirsten K. Ness, St. Jude Children’s Research Hospital
• Journal Title: Health Psychology
• Volume: Volume 33, Number 8
• Publisher: American Psychological Association | 2014-08-01, Pages 868-877
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1037/hea0000044
• Subjects: Psychology, Behavioral; Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery
• Keywords: Social Sciences; Psychology, Clinical; Psychology; risky sexual behavior; childhood cancer; survivors; adolescents; HUMAN-PAPILLOMAVIRUS; HEALTH-STATUS; HODGKINS-DISEASE; ADULT SURVIVORS; SUBSTANCE USE; SMOKING; PREVALENCE; MEDULLOBLASTOMA; RADIOTHERAPY; INFERTILITY

Abstract

Objective: To identify correlates of risky sexual behavior among adolescents surviving childhood cancer. Methods: The Child Health and Illness Profile-Adolescent Edition (CHIP-AE) was completed by 307 survivors of childhood cancer aged 15-20 years (M age at diagnosis 1.53 years; range 0-3.76). Univariate analyses were performed using χ2 and Fisher's Exact tests, and multivariable logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for risky sexual behaviors. Results: Diagnosis of central nervous system cancer (OR =.13, 95% CI:.02-.96, p <.05), no history of beer or wine consumption (OR =.20, CI:.06 -.68, p =.01), and fewer negative peer influences (OR =.28, CI:.09 -.84, p =.02) associated with decreased likelihood of sexual intercourse. Good psychological health (scores≥1.5 SD on the CHIP-AE Emotional Discomfort scale) associated with decreased risk of early intercourse (OR =.19, CI:.05-.77, p =.02), whereas high parental education (≥college degree) associated with decreased risk of multiple lifetime sexual partners (OR =.25, CI:.09 -.72, p <.01). Increased time from diagnosis (OR =.27, CI:.10 -.78, p =.02) and psychological health (OR =.09, CI:.02-.36, p <.01) associated with decreased risk of unprotected sex at last intercourse, whereas high parent education associated with increased risk (OR = 4.27, CI: 1.46 -12.52, p =.01). Conclusions: Risky sexual behavior in adolescents surviving childhood cancer is associated with cancer type, time since diagnosis, psychological health, alcohol use, and peer influences. Consideration of these factors may provide direction for future interventions designed to reduce adolescent sexual risk-taking.