Relationships among Depressive Symptoms, Sexually Transmitted Infections, and Pregnancy in African-American Adolescent Girls

Abstract 

Study Objective

To explore relationships among depressive symptoms, sexually transmitted infections (STI), and pregnancy in African-American adolescent girls.

Design

Retrospective chart review.

Setting

A hospital-based outpatient practice serving primarily African-American patients.

Participants

A total of 126 female patients ages 13–19 years who had ligase chain reaction (LCR) for N. gonorrhoeae and C. trachomatis.

Methods

Charts were reviewed for history of STI, history of pregnancy, LCR results, and a history of depressive symptoms as indicated by standardized provider notes and patient self-administered questionnaire. Data are compared using Fisher's exact test.

Results

Mean age was 16.6 years (±1.6 years); 19.8% of participants had a history of depressive symptoms, 40.5% had a history of STI, 8.7% had a prior pregnancy, and 18.2% had a positive LCR. Of patients with a history of depressive symptoms, 64% had a history of STI compared to 34.6% of those without depressive symptoms (P = 0.01). A positive LCR was found in 20% of patients with a history of depressive symptoms and 17.8% of patients without (P = 0.78). Of patients with a history of depressive symptoms, 12% had a prior pregnancy compared to 7.9% without such history (P = 0.45).

Conclusions

African-American adolescent females in our clinic with a history of depressive symptoms were more likely to have a history of STI. A greater percentage of patients with a history of depressive symptoms also had prior pregnancies and/or current STI. Sexually active adolescent girls should be screened for depressive symptoms as part of their evaluation for sexual risk behaviors.

Key Words: Adolescents, Sexually transmitted infections, Depression, Pregnancy