Impact of stress and depression symptoms on young women's sexual activity

Objective

Previously, we described the effects of young women’s depression and stress symptoms on poor contraceptive behavior and risk of unintended pregnancy. Here, we examine the impact of stress and depression on sexual activity, as a behavioral mechanism linking mental health and pregnancy.

 

Methods

We used panel data from a longitudinal, population-based, cohort study of 992 women ages 18-20yrs. Weekly journals measured relationship, reproductive, and health characteristics, contraceptive use, and pregnancy outcomes. We examined 27,130 journals from 952 women during the first study year. Our outcome was weekly sexual activity. Predictors were moderate/severe baseline stress (PSS-4) and depression (CESD-5) symptoms. Multi-level, mixed-effects, multivariable logistic regression estimated the effects of stress and depression on time-variant sexual activity, controlling for sociodemographic and reproductive covariates.

Results

Nearly a quarter of the sample had baseline stress (23%) and depression (24%) symptoms. Women reported being sexually active in 36% of weeks. Proportions of weekly sexual activity were higher among women with stress (43%) and depression (40%) compared to those without symptoms (35% and 35%, respectively, p’s<0.001). In multivariable models, women with stress had nearly twice the odds of having sex each week compared to women without stress (aOR 1.87, CI 1.20-2.90, p=0.005).

Conclusions

Building upon our previous findings, results suggest that stress has an additional effect on sexual behavior, further contributing to young women’s unintended pregnancy risk. We are continuing to examine the biological, behavioral and social pathways (e.g. fecundity, contraceptive efficacy and “weathering”) linking stress to unintended pregnancy during adolescence and young adulthood.