Predictors of vaginal and anal sex among adolescents with high versus low impulsive decision making styles

Background: Youth with mental health illnesses are an especially at-risk group for HIV compared to other youth. Little is known about the HIV preventive behaviors of adolescents with mental health illnesses and impulsive decision making styles. We examined how the Information Motivation Behavioral skills (IMB) model predicted vaginal/anal sex among adolescents with high and low impulsive decision making (IDM) styles.

Methods: This study was part of a larger longitudinal study that examined the efficacy of a family-based approach to reduce HIV risk among youth in mental health treatment. Adolescents (n=894) completed baseline surveys using ACASI, and multiple logistic regression was used to compare the variance explained by the IMB model (i.e. AIDS-related knowledge, safer sex intentions, and condom use self-efficacy) in vaginal/anal sex among high versus low IDM style youth.

Results: The sample consisted of 69% non-white adolescents, 56% females, and average age 15 years (s.d. 1.33). While controlling for age, AIDS-related knowledge and safer sex intentions were significantly related to ever had vaginal/anal sex for adolescents with high and low IDM styles. Safer sex intentions had a stronger association with ever had vaginal/anal sex for adolescents with low IDM style than for high IDM style youth.

Discussion: Adolescents with low IDM style and greater intentions to practice safer sex were more likely to have ever had vaginal/anal sex compared to those with high IDM style. Further theory testing is needed to better understand how impulsivity is associated with HIV-specific predictors of sexual activity for youth with mental health illnesses.