title: Risky sexual behavior in adolescent survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
abstract: OBJECTIVE
  To identify correlates of risky sexual behavior among adolescents surviving childhood cancer.
  
  
  METHODS
  The Child Health and Illness Profile-Adolescent Edition (CHIP-AE) was completed by 307 survivors of childhood cancer aged 15-20 years (M age at diagnosis 1.53 years; range 0-3.76). Univariate analyses were performed using χ² and Fisher's Exact tests, and multivariable logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for risky sexual behaviors.
  
  
  RESULTS
  Diagnosis of central nervous system cancer (OR = .13, 95% CI: .02-.96, p < .05), no history of beer or wine consumption (OR = .20, CI: .06-.68, p = .01), and fewer negative peer influences (OR = .28, CI: .09-.84, p = .02) associated with decreased likelihood of sexual intercourse. Good psychological health (scores ≥-1.5 SD on the CHIP-AE Emotional Discomfort scale) associated with decreased risk of early intercourse (OR = .19, CI: .05-.77, p = .02), whereas high parental education (≥ college degree) associated with decreased risk of multiple lifetime sexual partners (OR = .25, CI: .09-.72, p = .01). Increased time from diagnosis (OR = .27, CI: .10-.78, p = .02) and psychological health (OR = .09, CI: .02-.36, p < .01) associated with decreased risk of unprotected sex at last intercourse, whereas high parent education associated with increased risk (OR = 4.27, CI: 1.46-12.52, p = .01).
  
  
  CONCLUSIONS
  Risky sexual behavior in adolescents surviving childhood cancer is associated with cancer type, time since diagnosis, psychological health, alcohol use, and peer influences. Consideration of these factors may provide direction for future interventions designed to reduce adolescent sexual risk-taking.
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital.
authors.forename: James L
authors.initials: JL
authors.lastname: Klosky
authors.affiliation: Department of Psychology, Winona State University.
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Foster
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Zhenghong
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital.
authors.forename: Courtney
authors.initials: C
authors.lastname: Peasant
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Carrie R
authors.initials: CR
authors.lastname: Howell
authors.affiliation: Department of Pediatrics, Emory University/Children's Healthcare of Atlanta.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult