Stressful life events and sexual-risk behavior among adolescents and young adults in an employment training program

Introduction: No study to date has examined the influence of stressful life events on the sexual risk behavior of adolescent and young adults who are disconnected from school and the work force. Methods: We conducted a cross-sectional study of 617 African-American adolescents and young adults recruited from two employment training programs in Baltimore. Stressful life events were assessed using the Life Events Scale that asked about 29 different stressors experienced in the past 12 months. Sexual behavior included ever having sex, condom use, multiple partners, and age at first sex. Factor analysis was used to identify categories of stressors in the Life Events Scale. Multivariate logistic regression was used to examine the association between cumulative stressful life events and specific categories of stressful life events (i.e. neighborhood violence, familial, and material stressors) with sexual risk behavior when controlling for symptoms of depression and anxiety, substance use, age, and gender. Results: Cumulative stressful life events was significantly associated with multiple sexual partners (AOR: 1.06, 95%CI: 1.01-1.11, p<0.05). Neighborhood stressors, familial stressors, and material stressors also were significantly associated with multiple sexual partners after adjustment. Conclusion: These findings suggest that community-level factors, in addition to familial factors, are associated with sexual decision-making and highlight the need for comprehensive programs that address the mental and sexual health of youth in stressful environments.