The Relationship between STD Locus of Control and STD Acquisition among Adolescent Girls

Article excerpt

Sexually transmitted diseases (STDs) represent one of the leading public health problems for adolescent girls, their partners, and their neonates (Institute of Medicine, 1997). Concern has been raised about the lack of control adolescent girls and young adult women have over the most effective method of protection, namely condoms (Rosenthal, Cohen, & Stanberry, 1998). Previous research has demonstrated that partner insistence on condom use is related to both condom use and decreased STD acquisition (Rosenthal, Biro, Succop, Baker, & Stanberry, 1994). Other cross-sectional research has found that girls' perceptions that their partners are in control of STD acquisition are significantly correlated with the frequency with which the girls report using condoms (Rosenthal, Cohen, Biro, Lewis, Succop, & Stanberry, 1999). The limited control females have over condom use has led to interest in methods that could be female controlled, such as the female condom or topical microbicides (Coggins, 1999; Darroch & Frost, 19 99; El-Bassel, Krisbnam, Schilling, Witte, & Gilbert, 1998; Gollub, Stein, & El-Sadr, 1995; Rosenthal, Biro, & Stanberry, 1998). Topical microbicides can be used intravaginally--therefore under female control--to prevent STD acquisition. Topical microbicides work by either disrupting the organism's cell membrane (inhibiting replication of the organism and blocking infection) or altering the vaginal environment so as to reduce susceptibility (Rosenthal et al., 1998). For either topical microbicides or the female condom to be successful, girls need to believe that they, not others, are in control of preventive methods. Positive responses from male partners and ease of use are other aspects that may influence implementation of a female-controlled method.

Locus of control (LOG) is the degree to which persons believe that they are in control of what happens to them (internal), others are in control (external), or events are random (chance). As individuals move into adolescence, their locus of control typically becomes more internal (Nowicki, 1973). It is unclear whether this developmental trend continues throughout the adolescent period (Kulas, 1996). Our previous cross-sectional study indicated that for most loci of control, girls' beliefs about general health and STD acquisition were correlated, suggesting a general personality style (Rosenthal, Cohen, DeVellis, Biro, Lewis, Succop, & Stanberry, 1999). Attitudes regarding locus of control may change as a result of STD acquisition because other attitudes do appear to change with STD acquisition. For example, girls with multiple STD episodes view future STD acquisition as less negative (Rosenthal, Biro, Succop, Bernstein, & Stanberry, 1997). Sexually experienced girls who have not had an STD view STDs among the ir friends as less prevalent than those who are sexually inexperienced or have had an STD. This suggests that lack of STD acquisition in the presence of potential risk could lead to increased vulnerability or lack of protective behaviors (Rosenthal, Lewis, Succop, Burklow, & Biro, 1997).

The current study addressed the following three questions: Are the responses of adolescent girls' to a measure of STD locus of control correlated over approximately a 6-month period? Do internal, partner, and chance locus of control perceptions impact frequency of condom use or likelihood of acquiring an STD in the next 6 months? What is the contribution of recent STD acquisition to internal, partner, and chance LOC?

METHOD

Adolescent girls were recruited from an urban-based adolescent clinic to participate in a longitudinal study of psychosexual development and risk of STD acquisition. For 3 years, at approximately 6-month intervals, a female research assistant interviewed each of the adolescents who took part in the study (a total of seven visits). The sexually experienced girls received a medical STD evaluation. …