Feelings Matter: Depression Severity and Emotion Regulation in HIV/STI Risk-Related Sexual Behaviors
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Human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention models may not address psychological complexities among adolescents with mental illnesses. This study examined contextual factors related to HIV/STI risk among heterosexually active Black adolescents with mental illnesses to inform the development of targeted HIV/STI prevention strategies. Black adolescent males and females (aged 14–17) were recruited from outpatient mental health programs in Philadelphia, PA to complete a computer-assisted personalized interview on sociodemographics, sexual behaviors, and emotion regulation (N = 53). Two sample t-tests, Wilcoxon Rank Sum tests and regression modeling were used to examine differences in the study measures by gender and relationship status. Reports of sexual partner concurrency were high—both while already in a sexual relationship (67.3%) and multiple sexual partners in the same day (42.3%). Boys reported significantly more risk behaviors than girls. Sadness dysregulation predicted currently being in a relationship, older age at first oral sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters. Coping difficulties predicted a greater number of vaginal and oral sexual partners, and a lower age at first vaginal sex. Increasing depression severity was related to older age at first vaginal sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters in the past 3 months. This formative work suggests that coping mechanisms should be addressed in HIV/STI prevention research through the inclusion of activities targeted toward emotion regulation and decreasing sexual risk behaviors. Psycho-education and skills building may mitigate the psychopathology that contributes to HIV/STI risk in the target demographic.
KeywordsAdolescents Depression Emotion regulation HIV prevention Sexual partner concurrency
This research was funded by the Centers for Disease Control and Prevention (Minority AIDS Research Initiative) grant # U01PS003304 awarded to Dr. Brawner. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. The authors would like to acknowledge Naixue Cui and Rose Lu for their assistance with the data analyses. They are also grateful to the study participants, and thank the Made Aware with Care (MAC) research team and youth community advisory board for their assistance with data collection.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no competing interest.
This research involved participation of human participants and was approved by the Institutional Review Boards (IRBs) at the University of Pennsylvania and the Philadelphia Department of Public Health.
Informed consent was obtained from all participants. In the state of Pennsylvania, youth aged 14 and older can consent to both HIV/STI testing and mental health treatment, thus parental permission was not required for participation and participants consented rather than assented to the study (Juvenille Law Center 2006).
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