Psychological distress as a correlate of a biologically confirmed STI, risky sexual practices, self-efficacy and communication with male sex partners in African-American female adolescents

Psychol Health Med. 2009 May;14(3):291-300. doi: 10.1080/13548500902730119.


Previous research has established the association between psychosocial factors and risky sexual behaviour. However, few studies have examined the relationship between psychological distress and sexually transmitted infection (STI)/HIV-associated behaviours in African-American youth. The present study examined the association of psychological distress with STI/HIV-risk behaviour and psycho-social mediators of HIV-preventive behaviours. A sample of 715 African-American female adolescents, 15-21 years old, completed an audio computer assisted self-interviewing (ACASI) assessing sociodemographics, psychological distress, self-efficacy, communication and STI/HIV-associated sexual behaviours. Participants also provided self-collected vaginal swab specimens, which were assayed for STIs. High levels of psychological distress were defined as having a score of > or =7 on the eight-item Centre for Epidemiological Studies-Depression Scale. The overall prevalence of high levels of psychological distress was 44.5%. Logistic regression analyses revealed that adolescents with high psychological distress, relative to those with low psychological distress, were more likely to have a biologically confirmed STI (adjusted odd ratio (AOR) = 1.40), use condoms inconsistently (AOR = 1.50), not use condoms during their last casual sexual encounter (AOR = 1.89), have sex while high on alcohol or drugs (AOR = 1.47), have male sexual partners with concurrent female sexual partners (AOR = 1.98), have low condom use self-efficacy (AOR = 1.54), partner sexual communication self-efficacy (AOR = 1.77), refusal self-efficacy (AOR = 2.05) and be more fearful of communicating with their partners (AOR = 1.98). These findings, although preliminary, could be used to inform HIV intervention programs and physicians/clinicians providing regular health care maintenance to African-American female adolescents engaging in risky sexual behaviour.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Black or African American*
  • Communication*
  • Female
  • Health Surveys
  • Humans
  • Logistic Models
  • Risk-Taking
  • Self Efficacy*
  • Sexual Partners
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / ethnology*
  • Stress, Psychological
  • United States
  • Unsafe Sex / psychology*
  • Young Adult