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Between Synergy and Travesty: A Sexual Risk Syndemic Among Pregnant Latina Immigrant and Non-immigrant Adolescents

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Abstract

Substance use, intimate partner violence, and depression contribute to sexual risk individually, yet have not been evaluated as a syndemic for adolescents. Using data from 772 pregnant Latina adolescents, we evaluated these factors as a syndemic and tested the moderating role of immigration. Bivariate analyses showed syndemic score (OR = 1.40, p = 0.02) and severity (OR = 1.68, p = 0.006) were predictors for multiple sex partners, and syndemic score predicting STIs (OR = 1.15, p = 0.05). Syndemic severity remained significant in multivariate analyses for multiple sex partners (OR = 1.53, p = 0.04). Moderation analyses showed higher syndemic severity was associated with more condom use among immigrants (OR = 1.75, p = 0.04) and less condom use (OR = 0.07, p = 0.011) among those with separated orientation. Higher syndemic severity also predicted greater odds for multiple partners (OR = 2.40, p = 0.01) among immigrants. This evidence suggests a sexual risk syndemic exists among Latina adolescents. Research should continue exploring this phenomenon, particularly exploring the role immigration plays for sexual health.

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Acknowledgments

The research reported in this publication was supported by the National Institute Of Mental Health of the National Institutes of Health under Award Number P30MH062294. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in analyses were obtained from the Centering Pregnancy Plus study, which is registered at ClinicalTrials.gov (#NCT00628771).

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Authors and Affiliations

  1. Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, 135 College St, Suite 200, New Haven, CT, 06510, USA

    Isabel Martinez, Trace S. Kershaw, Jessica B. Lewis & Jeannette R. Ickovics

  2. Department of Psychology, Drexel University, Philadelphia, PA, USA

    Emily C. Stasko

  3. Clinical Directors Network, New York, NY, USA

    Jonathan N. Tobin

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  1. Isabel Martinez
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  2. Trace S. Kershaw
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Correspondence to Isabel Martinez.

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Isabel Martinez, Trace S. Kershaw, Jessica B. Lewis, Emily C. Stasko, Jonathan N. Tobin, and Jeannette R. Ickovics declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Martinez, I., Kershaw, T.S., Lewis, J.B. et al. Between Synergy and Travesty: A Sexual Risk Syndemic Among Pregnant Latina Immigrant and Non-immigrant Adolescents. AIDS Behav 21, 858–869 (2017). https://doi.org/10.1007/s10461-016-1461-3

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