Associations Between Depressive Symptoms and Sexual Risk Behavior in a Diverse Sample of Female Adolescents

Rubin, A.G.; Gold, M.A.; Primack, B.A.

doi:10.1016/j.jpag.2008.12.011

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Volume 22, Issue 5 , Pages 306-312, October 2009

Associations Between Depressive Symptoms and Sexual Risk Behavior in a Diverse Sample of Female Adolescents

A.G. Rubin, BA
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
M.A. Gold, DO
- Division of Student Affairs, University of Pittsburgh Student Health Service, Pittsburgh, Pennsylvania
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
B.A. Primack, MD, EdM, MS
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Address correspondence to: Brian A. Primack, MD, EdM, MS, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213

published online 10 July 2009.

Abstract

Study Objective

To determine associations between depressive symptoms, locus of control, and sexual outcomes in a predominantly African-American cohort of female adolescents.

Design

A computerized assessment was administered to participants as part of a larger randomized clinical trial. We assessed sexual risk behaviors (SRBs) via self-report, and we assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale. We used multivariate regression to determine associations between depressive symptoms and outcomes while controlling for covariates.

Setting

This was a secondary analysis of baseline data collected during a randomized clinical trial intended to prevent unintended pregnancy and sexually transmitted infections (STIs).

Participants

572 adolescent females, ages 13 to 21 years, were recruited via a hospital-based adolescent clinic and community-wide advertisements.

Main Outcome Measures

Participants reported on prior sexual intercourse, number of lifetime partners, frequency of intercourse, history of pregnancies and STIs, and locus of control.

Results

Two thirds of the sample had been sexually active. In a model that controlled for all covariates, those with a high level of depressive symptoms had higher odds of having had intercourse (adjusted OR=2.29; 95% CI=1.18–4.43). High levels of depressive symptoms were also independently associated with increased numbers of lifetime sexual partners and an external locus of control. However, when depression and locus of control were included in the same model, locus of control was not independently associated with SRBs.

Conclusion

These findings support other literature demonstrating an association between depression and SRBs, particularly in a largely African-American population. They further suggest that perceived control does not fully explain the relationship between depression and SRBs.

Key Words: Sexual behavior, Depression, Adolescent, African-American, Locus of control