Depression and HIV/STI: A Link Could Lead to Prevention Strategies
This study aimed to better understand the role of mental illness among sexually active heterosexual black adolescents.
Coping mechanisms should be addressed in HIV/sexually transmitted infection (STI) prevention research in the form of activities focusing on emotional regulation and on decreasing sexual risk behaviors, according to a study published in the Journal of Child and Family Studies.1
Nearly half of all adolescents between the ages of 13 and 19 in the United States are sexually active.2 However, while black adolescents comprise only 14% of the US population, they make up 63% of new cases of HIV reported in adolescents between the ages of 13 and 19, with heterosexual sexual contact being the primary mode of transmission.3
Researcher Bridgette M. Brawner, PhD, APRN, of the department of family and community health at the University of Pennsylvania School of Nursing in Philadelphia and colleagues examined the link between psychological factors that might hamper emotional regulation and HIV/STI risk-related behavior in heterosexual black adolescents. The design focused on the influence of depression and emotional regulation in sexual decision making.
“Blacks, adolescents, and people with mental illnesses are all disproportionately affected by HIV/STIs,” Dr Brawner said. “We know that the unique psychopathology of mental illness, including impulsivity and engaging in unprotected sex to alleviate depressed mood, may heighten one's HIV/STI risk.”
The researchers recruited 53 heterosexually active black adolescents between age 14 and 17 who were receiving outpatient mental health treatment from community-based mental health agencies, and asked them to complete a computer-assisted personal interview that included questions regarding sociodemographics and sexual behavior.
The survey data showed that coping difficulties resulted in both a higher number of sexual partners and a lower age of first vaginal sex, while increasing depression severity led to a lower number of sexual partners, an older age of first vaginal sex, and few instances of unprotected oral sex. Sadness also resulted in an older age of first oral sex, few sexual partners, and fewer instances of unprotected oral sex. Male participants reported a higher number of risk behaviors than female participants did.
“These findings indicate that different nuances of an adolescent's ability to regulate his/her emotions influence his/her behaviors, including decisions about sexual partnerships,” Dr Brawner said, “most notably, anger and sadness coping were significantly associated with several sexual risk behaviors.
“Our study indicates we need to better understand unique HIV/STI prevention needs among black adolescents with mental illnesses and that improving coping mechanisms to help regulate emotion should be addressed in HIV/STI prevention research.”
- Brawner BM, Jemmott LS, Wingood G, et al. Feelings matter: depression severity and emotion regulation in HIV/STI risk-related sexual behaviors [published online February 20, 2017/. J Child Fam Stud doi:10.1007/s10826-017-0674-z
- Centers for Disease Control and Prevention (CDC). Youth Risk Behavior Surveillance — United States, 2013. www.cdc.gov/mmwr/pdf/ss/ss6304.pdf. Accessed April 3, 2017.
- Centers for Disease Control and Prevention (CDC) (2013). HIV surveillance — Adolescents and young adults. National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention.www.cdc.gov/hiv/pdf/statistics_surveillance_Adolescents.pdf. Accessed April 3, 2017.