Shrier Lydia A, Walls Courtney, Lops Christopher, Feldman Henry A
Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
J Pediatr Adolesc Gynecol. 2011 Feb;24(1):10-4. doi: 10.1016/j.jpag.2010.04.002. Epub 2010 May 21.
Depressed young women are at particularly high risk of sexually transmitted infections (STIs), yet little is known about their condom use practices. This study sought (1) to describe condom use errors among depressed adolescent and young adult women and (2) to identify event- and individual-level correlates of incorrect use.
Depressed, sexually active outpatients ages 15-22 responded to a computer-based questionnaire, then reported on penile-vaginal sex events on a handheld computer several times a day for two weeks. For each sex event with a condom, incorrect condom use was defined as a response indicating incorrect use on at least one of five questions. Event- and individual-level correlates of incorrect use were analyzed using logistic regression adjusted for age and within-individual clustering.
Participants were recruited from two adolescent clinics, a psychiatric clinic, and a young parents' program of an urban children's hospital and collected data in the settings of their everyday lives.
Thirty-one young women contributed 143 condom use events to these analyses.
None.
Incorrect condom use.
Incorrect condom use was reported for 51% of condom use events. The most common error was not holding the condom on withdrawal (31%). Having sex to change mood, to relax, or for physical pleasure increased the odds of incorrect condom use, but was no longer significant when individual-level variables were included in the model. In the multiple logistic regression model, impulsiveness increased and stronger belief that mood affects sexual behaviors decreased the odds of incorrect condom use (adjusted OR 1.3 and 0.81, respectively).
Even if they use condoms, depressed adolescent and young adult women are at increased risk of STIs because they frequently use condoms incorrectly. Psychological factors may help identify depressed young women who are at particularly high risk of incorrect condom use.
抑郁的年轻女性感染性传播感染(STIs)的风险特别高,但对她们使用避孕套的行为了解甚少。本研究旨在(1)描述抑郁的青少年和年轻成年女性使用避孕套时的错误情况,以及(2)确定错误使用避孕套的事件层面和个体层面的相关因素。
年龄在15 - 22岁、患有抑郁症且有性活动的门诊患者回答一份基于计算机的问卷,然后在两周内每天多次通过手持计算机报告阴茎 - 阴道性行为事件。对于每次使用避孕套的性行为事件,错误使用避孕套被定义为在五个问题中至少有一个回答表明使用错误。使用逻辑回归分析错误使用避孕套的事件层面和个体层面的相关因素,并对年龄和个体内部聚类进行调整。
参与者从两家青少年诊所、一家精神科诊所和一家城市儿童医院的年轻父母项目中招募,并在他们的日常生活环境中收集数据。
31名年轻女性为这些分析提供了143次避孕套使用事件。
无。
错误使用避孕套。
51%的避孕套使用事件报告存在错误使用情况。最常见的错误是在抽出阴茎时未握住避孕套(31%)。为了改变情绪、放松或获得身体愉悦而进行性行为会增加错误使用避孕套的几率,但在模型中纳入个体层面变量后,该因素不再具有统计学意义。在多元逻辑回归模型中,冲动性增加以及更强烈地认为情绪会影响性行为会降低错误使用避孕套的几率(调整后的比值比分别为1.3和0.81)。
即使抑郁的青少年和年轻成年女性使用避孕套,她们感染性传播感染的风险仍会增加,因为她们经常错误地使用避孕套。心理因素可能有助于识别出特别容易错误使用避孕套的抑郁年轻女性。