Klosky James L, Foster Rebecca H, Li Zhenghong, Peasant Courtney, Howell Carrie R, Mertens Ann C, Robison Leslie L, Ness Kirsten K
Department of Psychology, St. Jude Children's Research Hospital.
Department of Psychology, Winona State University.
Health Psychol. 2014 Aug;33(8):868-77. doi: 10.1037/hea0000044. Epub 2013 Dec 23.
To identify correlates of risky sexual behavior among adolescents surviving childhood cancer.
The Child Health and Illness Profile-Adolescent Edition (CHIP-AE) was completed by 307 survivors of childhood cancer aged 15-20 years (M age at diagnosis 1.53 years; range 0-3.76). Univariate analyses were performed using χ² and Fisher's Exact tests, and multivariable logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for risky sexual behaviors.
Diagnosis of central nervous system cancer (OR = .13, 95% CI: .02-.96, p < .05), no history of beer or wine consumption (OR = .20, CI: .06-.68, p = .01), and fewer negative peer influences (OR = .28, CI: .09-.84, p = .02) associated with decreased likelihood of sexual intercourse. Good psychological health (scores ≥-1.5 SD on the CHIP-AE Emotional Discomfort scale) associated with decreased risk of early intercourse (OR = .19, CI: .05-.77, p = .02), whereas high parental education (≥ college degree) associated with decreased risk of multiple lifetime sexual partners (OR = .25, CI: .09-.72, p = .01). Increased time from diagnosis (OR = .27, CI: .10-.78, p = .02) and psychological health (OR = .09, CI: .02-.36, p < .01) associated with decreased risk of unprotected sex at last intercourse, whereas high parent education associated with increased risk (OR = 4.27, CI: 1.46-12.52, p = .01).
Risky sexual behavior in adolescents surviving childhood cancer is associated with cancer type, time since diagnosis, psychological health, alcohol use, and peer influences. Consideration of these factors may provide direction for future interventions designed to reduce adolescent sexual risk-taking.
确定儿童癌症幸存者中危险性行为的相关因素。
307名年龄在15至20岁的儿童癌症幸存者完成了《儿童健康与疾病概况-青少年版》（CHIP-AE）（诊断时的平均年龄为1.53岁；范围为0至3.76岁）。使用χ²检验和费舍尔精确检验进行单因素分析，并使用多变量逻辑回归模型计算危险性行为的比值比（OR）和95%置信区间（CI）。
中枢神经系统癌症诊断（OR = 0.13，95% CI：0.02 - 0.96，p < 0.05）、无啤酒或葡萄酒饮用史（OR = 0.20，CI：0.06 - 0.68，p = 0.01）以及较少的负面同伴影响（OR = 0.28，CI：0.09 - 0.84，p = 0.02）与性交可能性降低相关。良好的心理健康（在CHIP-AE情绪不适量表上得分≥ -1.5标准差）与早期性交风险降低相关（OR = 0.19，CI：0.05 - 0.77，p = 0.02），而高父母教育水平（≥大学学位）与多个性伴侣的终身风险降低相关（OR = 0.25，CI：0.09 - 0.72，p = 0.01）。自诊断以来时间增加（OR = 0.27，CI：0.10 - 0.78，p = 0.02）和心理健康（OR = 0.09，CI：0.02 - 0.36，p < 0.01）与最后一次性交时无保护性行为风险降低相关，而高父母教育水平与风险增加相关（OR = 4.27，CI：1.46 - 12.52，p = 0.01）。
儿童癌症幸存者中的危险性行为与癌症类型、诊断后的时间、心理健康、饮酒及同伴影响有关。考虑这些因素可能为未来旨在降低青少年性冒险行为的干预措施提供指导。
