202333 Impact of psychological distress on psychosocial mediators of HIV/STI-associated sexual risk behaviors among African-American female adolescents

Wednesday, November 11, 2009

Puja Seth, PhD , Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
Shilpa N. Patel, MPH , Department of Behavioral Sciences and Health Education, Emory University, Rollins School of Public Health, Atlanta, GA
Jessica Sales, PhD , Rollins School of Public Health Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
Ralph J. DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Gina M. Wingood, MPH ScD , Rollins School of Public Health Department of Health Sciences and Behavioral Education, Emory University, Atlanta, GA
Eve S. Rose, MSPH , Rollins School of Public Health, Department of Behavioral Science and Health Education, Emory University, Atlanta, GA
Background: Psychological distress has been associated with risky sexual practices. However, very few studies have examined the relationship between psychological distress and mediators of risky sexual practices among African-American youth. The present study examined psychological distress as a predictor of psychosocial mediators of HIV/STI-associated risk behaviors in African-American female adolescents.

Methods: A sample of African-American female adolescents (baseline: 715; 6-month: 612; 12-month: 605), 15-21 years, completed an ACASI assessing sociodemographics, psychological distress, and mediators of HIV/STI-associated behaviors. High levels of psychological distress were defined as ≥ 7 on the 8-item CES-D.

Results: Multiple logistic regression analyses, with age and intervention group as covariates, indicated that high levels of psychological distress predicted low partner communication self-efficacy (6-months: OR= 1.46, p=.02; 12-months: OR= 1.44, p=.03), high fear of communication (OR= 2.24, p=.00; OR= 1.84, p=.00), strong peer norms supporting high-risk behavior (OR= 1.46, p=.03; OR= 1.90, p=.00), low self-esteem (OR= 2.56, p=.00; OR= 2.42, p=.00), low social support (OR= 2.20, p=.00; OR= 1.73, p=.001), low family social support (OR= 2.54, p=.00; OR= 1.84, p=.00), and low peer social support (OR= 1.81, p=.00; OR= 1.49, p=.02) at both 6-and 12-months follow-up. Psychological distress also predicted high sexual adventurism at 12-months follow-up (OR= 1.44, p=.03).

Discussion: These findings suggest that discussion of psychological distress and coping mechanisms should be incorporated into HIV behavioral prevention programs. The increase of psychological resources could serve as a protective factor against negative consequences associated with psychological distress, low support, low self-efficacy, poor communication, and sexual adventurism.

Learning Objectives:
1. Identify psychological distress as a predictor of psychosocial mediators of HIV/STI-associated risk behaviors among African-American female adolescents. 2. Describe the importance of incorporating discussion of psychological distress and coping mechanisms in HIV behavioral prevention programs. 3. Discuss the clinical implications of the relationship between psychological distress and mediators of HIV/STI-associated sexual risk behaviors among African-American female adolescents.

Keywords: Mental Health, Sexual Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a NIH postdoctoral research fellow at Emory University in the Rollin School of Public Health, where my training is focused on STI/HIV research with women and adolescents.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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