Chung Tammy, Ye Feifei, Hipwell Alison E, Stepp Stephanie D, Miller Elizabeth, Borrero Sonya, Hawk Mary
a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.
b School of Education, University of Pittsburgh , Pittsburgh , Pennsylvania , USA.
Subst Abus. 2017 Jan-Mar;38(1):77-81. doi: 10.1080/08897077.2016.1263591. Epub 2016 Nov 29.
Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females.
The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16-18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18.
Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI.
Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.
某些性传播感染（STI）在女性中的患病率高于男性，在黑人女性中相对于白人女性患病率更高。确定性传播感染风险机制对于有效干预至关重要。作者测试了一个模型，其中酒精和大麻使用作为抑郁与行为问题与青少年女性性风险行为（SRB）和性传播感染之间关联的中介因素。
匹兹堡女孩研究是一项对女性进行的纵向观察性研究，每年对她们进行随访以追踪身心健康状况的发展过程。3个年龄最大的队列（N = 1750；56.8%为黑人，43.2%为白人）提供了16 - 18岁时物质使用、抑郁和行为问题、性风险行为及性传播感染的自我报告。一个路径模型测试了17岁时酒精和大麻使用作为中介机制，介导16岁时的抑郁和行为问题与18岁时的性风险行为和性传播感染之间的关联。
种族参与了两条风险途径。在一条途径中，白人女性报告饮酒量更大，这与更高的性风险行为相关。在另一条途径中，黑人女性报告性开始时间更早，这与随后的性风险行为相关。接受公共援助与性开始时间早和性传播感染独立相关。性风险行为而非物质使用介导了抑郁和行为问题与性传播感染之间的关联。
分别在年轻白人女性和黑人女性中发现了性风险行为和性传播感染风险途径中的种族差异，例如涉及饮酒和性开始时间早。抑郁和行为问题可能预示着年轻女性性风险行为和性传播感染的风险，值得关注以改善健康结果。
