title: Between Synergy and Travesty: A Sexual Risk Syndemic Among Pregnant Latina Immigrant and Non-immigrant Adolescents.
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.
authors.affiliation: 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@yale.edu.
authors.forename: Isabel
authors.identifier: http://orcid.org/0000-0002-7656-3833
authors.initials: I
authors.lastname: Martinez
authors.affiliation: 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.
authors.forename: Trace S
authors.initials: TS
authors.lastname: Kershaw
authors.affiliation: 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.
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Lewis
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Stasko
authors.affiliation: Clinical Directors Network, New York, NY, USA.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Tobin
authors.affiliation: 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.
authors.forename: Jeannette R
authors.initials: JR
authors.lastname: Ickovics
mesh_terms: D000069:Acculturation; D000293:Adolescent; D003863:Depression / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000209:etiology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D000066511:Intimate Partner Violence / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D047568:Unsafe Sex / Q000706:statistics & numerical data*
keywords: Depression; Health disparities; Immigration; Intimate partner violence; Substance use