A Prospective Study of Psychological Distress and Sexual Risk Behavior among Black Adolescent Females

Article excerpt

DiClemente, R.J., Wingood, G.M., Crosby, R.A. et al. (2001). A Prospective study of psychological distress and sexual risk behavior among black adolescent females. Pediatrics, 108, 1-6 (online).

Identifying the psychosocial factors that contribute to high-risk sexual behaviour is an important component in developing effective prevention education interventions. With respect to adolescent sexual risk reduction, little research has assessed the influence that psychological distress might have on adolescent sexual risk behaviour. The purpose of the DiClemente et al. study was to examine the association between black adolescent females level of psychological distress and their STD/HIV sexual risk behaviour. A second objective was to assess the association between psychological distress and adolescents attitudes about different aspects of their relationships with male sex partners.

The study sample consisted of 522 black females between the ages of 14 and 18 at the time of enrolment who had been sexually active in the previous 6 months. The women were recruited from neighbourhoods with high rates of unemployment, substance abuse, violence, and STDs. The average age of the women was 16 years and 81.2% were full-time students. At baseline and at 6-month follow-up, participants completed a self-administered questionnaire assessing sociodemographic characteristics, relational attitudes, perceptions of sexual risk behaviours, and psychological distress. To measure psychological distress, the 8-item Center for Epidemiological Studies Depression Scale (CES-D) was used. A score of 7 or higher on the CES-D is considered an indicator of psychological distress. The participants also completed a structured personal interview assessing sexual risk behaviours and provided a urine sample for pregnancy testing. Ninety percent of the sample completed the follow-up assessments.

The mean score on the CES-D was 6.9 with about 48% of the sample scoring 7 or higher and thus being defined as psychologically distressed. …