209529 Safe-sex among adolescents with serious mental illness: Pathways between parent-teen communication, self-efficacy, and condom use

Wednesday, November 11, 2009

Heather L. Hunter, PhD , Bradley Hasbro Children's Research Center, Warren Alpert Medical School of Brown University, Providence, RI
Wendy Hadley, PhD , Child and Adolescent Psychiatry, Brown University, Providence, RI
Larry K. Brown, MD , Department of Child and Adolescent Psychiatry/Bradley Hasbro Research Center, Brown University Medical School/Rhode Island Hospital, Providence, RI
Geri R. Donenberg, PhD , Dept. of Psychiatry, Institute for Juvenile Research, Univ. of Illinois at Chicago, Chicago, IL
Ralph J. DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Background: Adolescents with mental illness are at increased risk for HIV infection, STIs, and unintended pregnancy. While associations between effective condom negotiation, subsequent condom use, and prevention of negative health outcomes are well-established, predictors of safe-sex behavior among teens with mental illness remain nebulous. The purpose of the present study was to explore predictive pathways between parent-teen sexual communication, condom self-efficacy, condom negotiation, and condom use among adolescents with psychiatric illness. Methods: Participants included 798 adolescents (mean age = 14.9 years, 56.1% female, 57.2% sexually active) and their parents (89.5% female, 60% African American, and 31.5% married), recruited from mental health treatment centers for a multi-site randomized controlled trial aimed at preventing HIV infection among at-risk youth. For the purpose of the present study, baseline data regarding parent-adolescent communication (Miller Parent-Adolescent Sexual Communication Scale; Miller et. al., 1998), adolescent condom self-efficacy (Self-Efficacy for Condom Use; Prochaska, 1994), and adolescent-report regarding recent sexual activity (AIDS Risk Behavior Assessment; Donenberg et al., 2001) were examined. Results: Parent-adolescent sexual communication was found to predict a small but statistically significant proportion of the variance in adolescents' self-efficacy for using condoms. Self-efficacy, in turn, was a significant predictor of condom negotiation in adolescents' most recent relationship. Condom negotiation was found to predict nearly 80% of the variance in condom use. Conclusions: Study findings support links between communication, self-efficacy, and condom use, suggesting that adolescent self-efficacy for condom use and parent-teen communication about sexuality may be important areas for emphasis in future HIV prevention research.

Learning Objectives:
1) Describe rates of sexual activity, sexual communication with parents and partners, self efficacy for condom use, and protective behaviors (e.g., condom use) among a sample of adolescents with serious mental illness 2) Examine associations between parent-adolescent sexual communication, condom self-efficacy, condom negotiation, and condom use. 3) Evaluate group differences in self efficacy and safe-sex behavior among adolescents with and without a history of parent-child sexual communication.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have more than ten years of research training in pediatric psychology and research methods, am in the process of completing my PhD degree, and have been supervised by experienced research mentors in the completion of this study.
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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