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Chronic conditions, subjective wellbeing and risky sexual behaviour among adolescents and young adults

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Abstract

The purpose of this study is to clarify the relationship between having a chronic condition (CC) and several types of risky sexual behaviour (RSB) among adolescents and young adults. We used data from a multicentre cross-sectional study carried out on 14,431 adolescents from 137 French schools. Logistic regression was used to assess the association between several types of RSB and CCs among the 2680 participants aged 17 years or over who reported sexual intercourse. Survival analysis was conducted to assess the association between CCs and age at first sexual intercourse across the whole sample. Analyses were conducted separately by gender with and without adjustment for the parents’ education level, early menarche and subjective wellbeing (relationship with mother and father, depression, perceived health status and liking school). Among boys, having a CC was associated with a higher risk of RSB in both univariate (OR: 1.58 [95% CI: 1.10–2.27]) and multivariate analyses (aOR: 1.62 [95% CI: 1.11–2.38]). Among girls, the association between chronic condition and RSB in univariate analysis was non-significant (OR: 1.30 [95% CI: 0.97–1.76]) and disappeared after adjustment on subjective wellbeing (aOR: 1.08 [95% CI: 0.78–1.49]). There was no association between CC and age at first sexual intercourse.

   Conclusion: There were major gender differences. Boys with a CC were more prone to engage in RSB independent of their subjective wellbeing, whereas in girls, subjective wellbeing seemed to mediate the relationship between CC and RSB. Clinicians should be aware of those gender differences in order to deliver preventive strategies regarding sexuality that target both genders.

What is Known:

• Young people with chronic conditions have a higher likelihood of engaging in risky sexual behaviour.

• Engaging in such behaviours can be much more costly, as it can weaken their underlying state of health.

What is New:

• We found major gender differences. Boys were more prone to engage in risky behaviour independent of their subjective wellbeing, whereas in girls, it seemed to play an important role.

• By understanding how risky sexual behaviour differs according to gender, clinicians can deliver prevention messages that target both genders.

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Data Availability

The dataset analysed for this manuscript is available from the corresponding author upon request.

Abbreviations

CC:

Chronic conditions

RSB:

Risky sexual behaviour

References

  1. Suris J-C, Michaud P-A, Viner R (2004) The adolescent with a chronic condition. Part I: developmental issues. Arch Dis Child 89:938–942. https://doi.org/10.1136/adc.2003.045369

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sawyer SM, Drew S, Yeo MS, Britto MT (2007) Adolescents with a chronic condition: challenges living, challenges treating. In: Lancet Lond Engl. https://pubmed.ncbi.nlm.nih.gov/17467519/. Accessed 30 Jul 2021

  3. Louis-Jacques J, Samples C (2011) Caring for teens with chronic illness: risky business? Curr Opin Pediatr 23:367–372. https://doi.org/10.1097/MOP.0b013e3283481101

    Article  PubMed  Google Scholar 

  4. Suris J-C, Parera N (2005) Sex, drugs and chronic illness: health behaviours among chronically ill youth. Eur J Public Health 15:484–488. https://doi.org/10.1093/eurpub/cki001

    Article  PubMed  Google Scholar 

  5. Miauton L, Narring F, Michaud P-A (2003) Chronic illness, life style and emotional health in adolescence: results of a cross-sectional survey on the health of 15–20-year-olds in Switzerland. Eur J Pediatr 162:682–689. https://doi.org/10.1007/s00431-003-1179-x

    Article  PubMed  Google Scholar 

  6. Jones SE, Lollar DJ (2008) Relationship between physical disabilities or long-term health problems and health risk behaviors or conditions among US high school students. In: J Sch Health. https://pubmed.ncbi.nlm.nih.gov/18387024/. Accessed 2 Dec 2021

  7. Suris J-C, Michaud P-A, Akre C, Sawyer SM (2008) Health risk behaviors in adolescents with chronic conditions. In: Pediatrics. https://pubmed.ncbi.nlm.nih.gov/18977960/. Accessed 30 Jul 2021

  8. Nylander C, Seidel C, Tindberg Y (2014) The triply troubled teenager--chronic conditions associated with fewer protective factors and clustered risk behaviours. In: Acta Paediatr Oslo Nor 1992. https://pubmed.ncbi.nlm.nih.gov/24117768/. Accessed 30 Jul 2021

  9. Choquet M, Du Pasquier FL, Manfredi R (1997) Sexual behavior among adolescents reporting chronic conditions: a French national survey. J Adolesc Health Off Publ Soc Adolesc Med 20:62–67. https://doi.org/10.1016/S1054-139X(96)00091-2

    Article  CAS  Google Scholar 

  10. Surís JC, Resnick MD, Cassuto N, Blum RW (1996) Sexual behavior of adolescents with chronic disease and disability. J Adolesc Health Off Publ Soc Adolesc Med 19:124–131. https://doi.org/10.1016/1054-139X(95)00282-W

    Article  Google Scholar 

  11. Scott ME, Wildsmith E, Welti K, Ryan S, Schelar E, Steward-Streng NR (2011) Risky adolescent sexual behaviors and reproductive health in young adulthood. Perspect Sex Reprod Health 43:110–118. https://doi.org/10.1363/4311011

    Article  PubMed  Google Scholar 

  12. Olesen T, Jensen K, Nygård M, Tryggvadottir L, Sparén P, Hansen B, Liaw K, Kjaer (2012) Young age at first intercourse and risk-taking behaviours--a study of nearly 65 000 women in four Nordic countries. Eur J Public Health 22:220–4. https://doi.org/10.1093/eurpub/ckr055.

  13. Spriggs AL, Halpern CT (2008) Timing of sexual debut and initiation of postsecondary education by early adulthood. Perspect Sex Reprod Health 40:152–161. https://doi.org/10.1363/4015208

    Article  PubMed  Google Scholar 

  14. Santos T, Ferreira M, Simões MC, Machado MC, de Matos MG (2014) Chronic condition and risk behaviours in Portuguese adolescents. Glob J Health Sci 6:227–236. https://doi.org/10.5539/gjhs.v6n2p227

    Article  PubMed  PubMed Central  Google Scholar 

  15. Patton GC, McMorris BJ, Toumbourou JW, Hemphill SA, Donath S, Catalano RF (2004) Puberty and the onset of substance use and abuse. Pediatrics 114:e300-306. https://doi.org/10.1542/peds.2003-0626-F

    Article  PubMed  Google Scholar 

  16. Gubelmann A, Berchtold A, Barrense-Dias Y, Akre C, Newman CJ, Suris J-C (2018) Youth with chronic conditions and risky behaviors: an indirect path. J Adolesc Health Off Publ Soc Adolesc Med 63:785–791. https://doi.org/10.1016/j.jadohealth.2018.06.021

    Article  Google Scholar 

  17. Gaudineau A, Ehlinger V, Vayssiere C, Jouret B, Arnaud C, Godeau E (2010) Factors associated with early menarche: results from the French Health Behaviour in School-aged Children (HBSC) study. BMC Public Health 10:175. https://doi.org/10.1186/1471-2458-10-175

    Article  PubMed  PubMed Central  Google Scholar 

  18. Goldenring JM, Rosen DS (2004) Getting into adolescent heads: an essential update. CONTEMPORARY PEDIATRICS-MONTVALE 21:64–92

  19. Verhoof E, Maurice-Stam H, Heymans H, Grootenhuis M (2013) Health-related quality of life, anxiety and depression in young adults with disability benefits due to childhood-onset somatic conditions. Child Adolesc Psychiatry Ment Health 7:12. https://doi.org/10.1186/1753-2000-7-12

    Article  PubMed  PubMed Central  Google Scholar 

  20. Katon W, Richardson L, Russo J, McCarty CA, Rockhill C, McCauley E, Richards J, Grossman DC (2010) Depressive symptoms in adolescence: the association with multiple health risk behaviors. Gen Hosp Psychiatry 32:233–239. https://doi.org/10.1016/j.genhosppsych.2010.01.008

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tremblay S, Dahinten S, Kohen D (2003) Factors related to adolescents’ self-perceived health. Health Rep 14(Suppl):7–16

    PubMed  Google Scholar 

  22. Svetaz MV, Ireland M, Blum R (2000) Adolescents with learning disabilities: risk and protective factors associated with emotional well-being: findings from the National Longitudinal Study of Adolescent Health. J Adolesc Health 27:340–348. https://doi.org/10.1016/S1054-139X(00)00170-1

    Article  CAS  PubMed  Google Scholar 

  23. Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM, Jones J, Tabor J, Beuhring T, Sieving RE, Shew M, Ireland M, Bearinger LH, Udry JR (1997) Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA 278:823–832. https://doi.org/10.1001/jama.278.10.823

    Article  CAS  PubMed  Google Scholar 

  24. Blum RW, Kelly A, Ireland M (2001) Health-risk behaviors and protective factors among adolescents with mobility impairments and learning and emotional disabilities. J Adolesc Health Off Publ Soc Adolesc Med 28:481–490. https://doi.org/10.1016/s1054-139x(01)00201-4

    Article  CAS  Google Scholar 

  25. Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, Fatusi A, Currie C (2012) Adolescence and the social determinants of health. Lancet Lond Engl 379:1641–1652. https://doi.org/10.1016/S0140-6736(12)60149-4

    Article  Google Scholar 

  26. Repères et références statistiques sur les enseignements, la formation et la recherche (2014). In: Enseign Rech. https://www.enseignementsup-recherche.gouv.fr/fr/reperes-et-references-statistiques-sur-les-enseignements-la-formation-et-la-recherche-2014-47689. Accessed 2 Dec 2021

  27. WHO Adolescent health. https://www.who.int/southeastasia/health-topics/adolescent-health. Accessed 14 Dec 2022

  28. Bajos N, Rahib D, Lydié N (2018) Baromètre santé 2016. Genre et sexualité. https://www.santepubliquefrance.fr/determinants-de-sante/sante-sexuelle/documents/enquetes-etudes/barometre-sante-2016.-genre-et-sexualite. Accessed 26 Nov 2021

  29. Madkour AS, de Looze M, Halpern CT, Farhat T, ter Bogt TFM, Gabhainn SN, Currie C, Godeau E (2014) Macro-level age norms for the timing of sexual initiation and adolescents’ early sexual initiation in 17 European countries. J Adolesc Health 55:114–121. https://doi.org/10.1016/j.jadohealth.2013.12.008

    Article  PubMed  PubMed Central  Google Scholar 

  30. Stein RE, Bauman LJ, Westbrook LE, Coupey SM, Ireys HT (1993) Framework for identifying children who have chronic conditions: the case for a new definition. J Pediatr 122:342–347. https://doi.org/10.1016/s0022-3476(05)83414-6

    Article  CAS  PubMed  Google Scholar 

  31. Revah-Levy A, Birmaher B, Gasquet I, Falissard B (2007) The Adolescent Depression Rating Scale (ADRS): a validation study. In: BMC Psychiatry. https://pubmed.ncbi.nlm.nih.gov/17222346/. Accessed 19 Nov 2021

  32. Revah-Levy A, Speranza M, Barry C, Hassler C, Gasquet I, Moro M-R, Falissard B (2011) Association between Body Mass Index and depression: the “fat and jolly” hypothesis for adolescents girls. BMC Public Health 11:649. https://doi.org/10.1186/1471-2458-11-649

    Article  PubMed  PubMed Central  Google Scholar 

  33. StataCorp. (2019) Stata Statistical Software: Release 16. StataCorp LLC, College Station, TX

    Google Scholar 

  34. White IR, Royston P, Wood AM (2011) Multiple imputation using chained equations: issues and guidance for practice. Stat Med 30:377–399. https://doi.org/10.1002/sim.4067

    Article  PubMed  Google Scholar 

  35. Sawyer S, Duncan R, Drew S (2007) Adolescents with chronic disease - the double whammy. In: Aust Fam Physician. https://pubmed.ncbi.nlm.nih.gov/17676185/. Accessed 27 Oct 2021

  36. Courtenay W (2003) Key determinants of the health and well-being of men and boys. Int J Mens Health 2:1–30. https://doi.org/10.3149/jmh.0201.1

    Article  Google Scholar 

  37. Leadbeater B, Kuperminc GP, Blatt SJ, Hertzog C (1999) A multivariate model of gender differences in adolescents’ internalizing and externalizing problems. Dev Psychol 35:1268–82. https://doi.org/10.1037//0012-1649.35.5.1268.

  38. Courtenay WH (1982) (2000) Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med 50:1385–1401. https://doi.org/10.1016/s0277-9536(99)00390-1

    Article  Google Scholar 

  39. Engelen MM, Knoll JL, Rabsztyn PRI, Maas-van Schaaijk NM, van Gaal BGI (2020) Sexual health communication between healthcare professionals and adolescents with chronic conditions in western countries: an integrative review. Sex Disabil 38:191–216. https://doi.org/10.1007/s11195-019-09597-0

    Article  Google Scholar 

  40. Blum RW (1997) Sexual health contraceptive needs of adolescents with chronic conditions. Arch Pediatr Adolesc Med 151:290–297. https://doi.org/10.1001/archpedi.1997.02170400076014

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank the physicians who helped us assess chronic conditions: Maude Ludot, Carole Harbulot, Claire Grimwood, Tristan Langlais, Alexandra Loisel, Benoist Grégoire, Gaëlle Hirsch and Manuelle Stern.

Funding

This work was supported by La Fondation pour la Recherche Médicale (FRM) (grant number FDM 202006011199). The first author received funding from the FRM for her 3-year PhD program. The funding source had no role in the study design, the collection, analysis and interpretation of the data, the writing of the report or the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France

    Nour Ibrahim, Christine Hassler, Catherine Jousselme, Caroline Barry, Hervé Lefèvre, Bruno Falissard, Jean Bouyer & Alexandra Rouquette

  2. French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France

    Nour Ibrahim & Hervé Lefèvre

  3. Fondation Vallée, Paris-Saclay University, Gentilly, France

    Catherine Jousselme

  4. AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port-Royal, 75014, Paris, France

    Hervé Lefèvre

  5. Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France

    Bruno Falissard, Jean Bouyer & Alexandra Rouquette

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  1. Nour Ibrahim
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Contributions

All authors contributed to the study conception and design. Analysis was performed by Nour Ibrahim and Jean Bouyer. Interpretation of data was performed by Nour Ibrahim, Jean Bouyer, Caroline Barry, Christine Hassler and Alexandra Rouquette. The first draft of the manuscript was written by Nour Ibrahim, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nour Ibrahim.

Ethics declarations

Ethics approval

The study protocol was approved by the National Advisory Ethics Committee and by the French National Commission on Computer Science and Liberties, the national review board for surveys involving people and data management (February 2013 ref. No. 912523).

Consent to participate

Informed consent to participate in the survey was obtained from all participants (or their parent or legal guardian in the case of adolescents under 18).

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Participants (or their parent or legal guardian in the case of children under 18) signed informed consent regarding publishing their data.

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The authors declare no competing interests.

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Communicated by Peter de Winter

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Ibrahim, N., Hassler, C., Jousselme, C. et al. Chronic conditions, subjective wellbeing and risky sexual behaviour among adolescents and young adults. Eur J Pediatr 182, 1163–1171 (2023). https://doi.org/10.1007/s00431-022-04784-2

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