title: The emotional experience of intercourse and sexually transmitted diseases: a decision-tree analysis.
abstract: BACKGROUND
  Epidemiologic data document high risks for many sexually transmitted diseases (STDs) among US adolescents and young adults.
  
  
  OBJECTIVE
  This case-control study used decision trees to investigate the relationship between STD incidence and emotional reactions to intercourse.
  
  
  METHODS
  For this study, 188 adolescents and young adults (mean age, 24.9 years [SD = 8.2]) at a regional public STD clinic completed a behavioral and psychological questionnaire and underwent a workup for STD.
  
  
  RESULTS
  The prevalence of STD in this group was 44.8%. Decision-tree analysis identified emotional reactions to intercourse that were associated with STD diagnosis for some patients: feeling good about oneself after sex half the time or less (OR = 3.21; 95% CI = 1.73-5.95), feeling comfortable during sex half the time or less (OR = 2.17; 95% CI = 1.07-4.40), and feeling angry after sex (OR = 1.90; 95% CI = 0.91-3.99). Findings of a logistic regression model of emotional reactions to intercourse were significant (chi-square = 24.6; df = 8; P < 0.002), but adding behavioral variables did not improve prediction.
  
  
  CONCLUSIONS
  For some of these young adults at the time of life when they are at highest risk of STD, emotional factors have higher odds ratios for STD diagnosis than the traditionally assessed behavioral variables. This underscores the need for interventions targeted to specific subgroups and for readily available mental health services.
authors.affiliation: Department of Psychology , University of Virginia, Charlottesville, Virginia 22903, USA.
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Whitten
authors.forename: Michael F
authors.initials: MF
authors.lastname: Rein
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Land
authors.forename: N Dickon
authors.initials: ND
authors.lastname: Reppucci
authors.forename: Eric
authors.initials: E
authors.lastname: Turkheimer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D016022:Case-Control Studies; D003075:Coitus / Q000523:psychology*; D003657:Decision Making; D003663:Decision Trees; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014768:Virginia / Q000453:epidemiology