title: The association between stress, coping, and sexual risk behaviors over 24 months among African-American female adolescents.
abstract: Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African-American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6, 12, 18, and 24 months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p = .018), inconsistent condom use (p = .011), and not using a condom at last sex (p = .002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population.
authors.affiliation: a Department of Biostatistics and Bioinformatics, Rollins School of Public Health , Emory University , Atlanta, GA , USA.
authors.forename: Erin N
authors.initials: EN
authors.lastname: Hulland
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Swartzendruber
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.forename: Eve S
authors.initials: ES
authors.lastname: Rose
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011446:Prospective Studies; D012309:Risk-Taking; D021841:Safe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D012747:Sexual Partners; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: African-American adolescent women; HIV prevention intervention; coping; sexual risk behavior; stress