Seth Puja, Lang Delia L, Diclemente Ralph J, Braxton Nikia D, Crosby Richard A, Brown Larry K, Hadley Wendy, Donenberg Geri R
Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA 30322, USA.
Sex Health. 2012 Jul;9(3):240-6. doi: 10.1071/SH10098.
Adolescents with a history of psychiatric disorder(s) are particularly vulnerable to contracting sexually transmissible infections (STIs) as a result of psychological and emotional states associated with higher rates of risky sexual behaviour. The present study examined gender differences in sexual risk behaviours and STI among adolescents in mental health treatment.
Three hundred and seventy nine sexually active adolescents, aged 13-18 years, from a larger multisite study, who received mental health treatment during the past year, completed an audio computer-assisted self interview assessing sociodemographics, psychiatric symptomatology and HIV/STI risk behaviours, and provided urine specimens tested for STI.
After controlling for covariates, multivariate logistic regression models indicated that female adolescents were more likely to have had an HIV test (adjusted odds ratio (AOR)=3.2, P=0.0001), obtain their HIV test results (AOR=2.9, P=0.03), refuse sex out of fear for STI acquisition (AOR=1.7, P=0.04), or avoid a situation that might lead to sex (AOR=2.4, P=0.001), and were less likely to have a casual sex partner (AOR=0.40, P=0.002). Additionally, females were more likely to report inconsistent condom use (AOR=2.60, P=0.001) and have a STI (AOR=9.1, P=0.0001) than their male counterparts.
Female adolescents receiving mental health treatment were more than nine times as likely to have an STI and more likely to use condoms inconsistently. The standard of care for mental health practice for adolescents should include referrals for STI screening and treatment as well as assessment and discussion of risky sexual behaviours as part of the treatment plan when indicated. Effective programs should address gender-specific communication and behavioural skills.
有精神疾病史的青少年由于与高风险性行为发生率相关的心理和情绪状态，特别容易感染性传播感染（STIs）。本研究调查了接受心理健康治疗的青少年在性风险行为和性传播感染方面的性别差异。
来自一项更大规模多地点研究的379名年龄在13 - 18岁的性活跃青少年，他们在过去一年接受了心理健康治疗，完成了一次音频计算机辅助的自我访谈，评估社会人口统计学、精神症状学和艾滋病毒/性传播感染风险行为，并提供尿液样本进行性传播感染检测。
在控制协变量后，多变量逻辑回归模型表明，女性青少年更有可能进行过艾滋病毒检测（调整后的优势比（AOR）=3.2，P = 0.0001），获取其艾滋病毒检测结果（AOR = 2.9，P = 0.03），出于对感染性传播感染的恐惧而拒绝性行为（AOR = 1.7，P = 0.04），或避免可能导致性行为的情况（AOR = 2.4，P = 0.001），并且不太可能有随意的性伴侣（AOR = 0.40，P = 0.002）。此外，与男性青少年相比，女性更有可能报告避孕套使用不一致（AOR = 2.60，P = 0.001）和患有性传播感染（AOR = 9.1，P = 0.0001）。
接受心理健康治疗的女性青少年感染性传播感染的可能性是男性的九倍多，并且更有可能不规律地使用避孕套。青少年心理健康实践的护理标准应包括在有指征时将性传播感染筛查和治疗的转诊以及对高风险性性行为的评估和讨论作为治疗计划的一部分。有效的项目应解决针对性别的沟通和行为技能问题。
