Psychological Distress,Substance Use,and HIV/STI Risk Behaviors Among Youth |
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Authors: | Katherine S Elkington José A Bauermeister Marc A Zimmerman |
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Institution: | (1) HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive #15, New York, NY 10032, USA;(2) Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA |
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Abstract: | Psychological distress has been inconsistently associated with sexual risk behavior in youth, suggesting additional factors,
such as substance use, may explain this relationship. The mediating or moderating role of substance use on the relationship
between psychological distress and sexual risk behaviors was prospectively examined over the four high school years in a sample
of urban youth (N = 850; 80% African American; 50% female). Growth curve modeling was used to estimate changes in sexual risk
across adolescence and to test its association to psychological distress symptoms and frequency of substance use. Substance
use was associated with psychological distress. Greater psychological distress was associated with increased sexual intercourse
frequency, decreased condom use, and increased number of partners. Substance use fully mediated the relationship between psychological
distress and intercourse frequency and condom use, and partially mediated the relationship between psychological distress
and number of partners. We found no differences in mediation by sex or race/ethnicity and no evidence to support moderation
of psychological distress and substance use on sexual risk. Findings suggest that psychological distress is associated with
sexual risk because youth with greater psychological distress are also more likely to use substances. Practical implications
for adolescent HIV/STI prevention are discussed. |
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