Mental Illnesses May Heighten Risk of HIV, Sexually Transmitted Infections

Psychoeducation and skill building could help mitigate the emotion-behavior link that contributes to the risk of HIV and sexually transmitted infections (STI) among black adolescents.

In the United States, nearly half of all adolescents aged 13 to 19 years are sexually active. But black youth, who account for only 14% of the population, represent 63% of new HIV cases among adolescents. Furthermore, more than 2 million adolescents experience a major depressive episode.

In a study published in the Journal of Child and Family Studies, investigators sought to determine whether unique psychological factors that hamper emotional regulation are responsible for differences in HIV/STI risk-related sexual behaviors among heterosexually active black youth with mental illness.

The investigators primarily focused on depression and emotion regulation in the study to identify how contextual factors related to HIV/STI risk influence sexual decision-making.

Black adolescent males and females aged 14 to 17 years were recruited from outpatient mental health programs in Philadelphia, PA, to complete a computer-assisted personalized interview regarding sociodemographics, sexual behaviors, and emotion regulation.

To examine the differences in the study measures by gender and relationship status, the investigators used Wilcoxon Rank Sum test and regression modeling.

Reports of sexual partner concurrency were high, with 67.3% already in a sexual relationship and 42.3% with multiple sexual partners in the same day. Males reported significantly higher risk behaviors than girls.

Sadness dysregulation predicted currently being in a relationship, older age at first oral sex experience, fewer vaginal sexual partners, and fewer unprotected oral sexual encounters. Coping difficulties predicted a greater number of vaginal and oral sexual partners, and a lower age at first vaginal sex, according to the study.

An increase in depression severity was related to older age at first vaginal sex, fewer vaginal sexual partners, and fewer unprotected oral sexual encounters in the past 3 months.

“Blacks, adolescents, and people with mental illnesses are all disproportionately affected by HIV/STIs,” said lead author Bridgette M. Brawner, PhD, APRN. “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. Our study indicates we need to better understand unique HIV/STI prevention needs among black adolescents with mental illnesses and that improve coping mechanisms to help regulate emotion should be addressed in HIV/STI prevention research.”