Fear of abuse and STD knowledge: Interactive effects on adolescent girls' risky sexual behavior

Background: Fear of abuse resulting from negotiating condom use with a male sex partner may place adolescent females at heightened risk for acquiring sexually transmitted diseases (STDs). Although knowledge about STDs may be a protective factor, lack of knowledge may also place adolescent females at risk especially if they fear being abused when negotiating condom use. This study examined the interactive effects of STD knowledge and fear of abuse on several sexual risk behaviors in an African American sample of adolescent girls. Methods: 715 African American adolescent girls, 14 to 21 years of age were recruited from a variety of health clinics. Participants were assessed on fear of abuse due to condom negotiation, knowledge of STDs and several sexual risk behaviors. Results: Overall, 75% of adolescent girls reported inconsistent condom use in the past 60 days. Fear of abuse due to condom negotiation moderated the relation between STD knowledge and consistent condom use. Under relatively higher levels of fear, girls with lower STD knowledge compared to girls with higher STD knowledge were more likely to have inconsistent condom use in the past 60 days (89% vs. 80%, Χ²= 4.32, p=.04) and during last sexual intercourse with main partner (76% vs. 70%, Χ²= 8.06, p=.01). Under lower levels of fear, there was no relation between STD knowledge and inconsistent condom use. Conclusion: These findings highlight the need for combining dating violence prevention activities with STD and HIV prevention programs.