Gender differences in sexual risk behaviours and sexually transmissible infections among adolescents in mental health treatment.
BACKGROUND
Adolescents with a history of psychiatric disorder(s) are particularly vulnerable to contracting sexually transmissible infections (STIs) as a result of psychological and emotional states associated with higher rates of risky sexual behaviour. The present study examined gender differences in sexual risk behaviours and STI among adolescents in mental health treatment.


METHODS
Three hundred and seventy nine sexually active adolescents, aged 13-18 years, from a larger multisite study, who received mental health treatment during the past year, completed an audio computer-assisted self interview assessing sociodemographics, psychiatric symptomatology and HIV/STI risk behaviours, and provided urine specimens tested for STI.


RESULTS
After controlling for covariates, multivariate logistic regression models indicated that female adolescents were more likely to have had an HIV test (adjusted odds ratio (AOR)=3.2, P=0.0001), obtain their HIV test results (AOR=2.9, P=0.03), refuse sex out of fear for STI acquisition (AOR=1.7, P=0.04), or avoid a situation that might lead to sex (AOR=2.4, P=0.001), and were less likely to have a casual sex partner (AOR=0.40, P=0.002). Additionally, females were more likely to report inconsistent condom use (AOR=2.60, P=0.001) and have a STI (AOR=9.1, P=0.0001) than their male counterparts.


CONCLUSIONS
Female adolescents receiving mental health treatment were more than nine times as likely to have an STI and more likely to use condoms inconsistently. The standard of care for mental health practice for adolescents should include referrals for STI screening and treatment as well as assessment and discussion of risky sexual behaviours as part of the treatment plan when indicated. Effective programs should address gender-specific communication and behavioural skills.
Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA 30322, USA. pseth@cdc.gov
Puja
P
Seth
Delia L
DL
Lang
Ralph J
RJ
Diclemente
Nikia D
ND
Braxton
Richard A
RA
Crosby
Larry K
LK
Brown
Wendy
W
Hadley
Geri R
GR
Donenberg
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001294:Attitude to Health; D003155:Community Mental Health Centers / Q000458:organization & administration; D015897:Comorbidity; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health / Q000706:statistics & numerical data*; D012309:Risk-Taking; D017678:Sex Distribution; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*