Depression as a correlate of risky sexual practices, self-efficacy, and communication with male sex partners in African-American female adolescents

BACKGROUND: Previous research has established the association between psychosocial factors and risky sexual behavior. However, few studies have examined the relationship between depression and STI/HIV-associated behaviors in African-American youth. The present study examined the association of depressive symptoms with STI/HIV-risk behavior and psychosocial mediators of HIV-preventive behaviors. METHODS: A sample of 715 African-American female adolescents, 15-21 years old, completed an Audio Computer Assisted Survey Interview (ACASI) assessing sociodemographics, depressive symptomatology, self-efficacy, communication, and STI/HIV-associated sexual behaviors. High depressive symptoms were defined as having a score of ≥ 7 on the 8-item CES-D. RESULTS: The overall prevalence of high depressive symptoms was 44.5%. Logistic regression analyses revealed that adolescents with high depressive symptoms, relative to those with low depressive symptoms, were more likely to use condoms inconsistently (OR=1.50), not use condoms during their last casual sexual encounter (OR=1.89), have sex while high on alcohol or drugs (OR=1.47), have male sexual partners with concurrent sexual partners (OR=1.98), have low condom use self-efficacy (OR=1.54), partner sexual communication self-efficacy (OR=1.77), refusal self-efficacy (OR=2.05), and be more fearful of communicating with their partners (OR=1.98). CONCLUSIONS: The findings suggest that screening for depressive symptoms should be included in regular health care maintenance and highlight the importance of assessing depressive symptoms among African-American female adolescents as a marker for, or antecedent of, high-risk sexual behavior. HIV intervention programs should increasingly be tailored towards increasing psychological resources and coping mechanisms to buffer against potential negative consequences of depressive symptoms.