Okumu Moses, Ombayo Bernadette K, Small Eusebius, Ansong David
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada.
School of Social Work, University of Texas, Arlington, Arlington, TX, USA.
Int J Behav Med. 2019 Jun;26(3):297-305. doi: 10.1007/s12529-019-09783-6.
The present study aims to (1) identify classes of psychosocial syndemics among adolescents in the U.S. based on psychological factors, such as depression and suicidal ideation, and social factors, such as binge drinking, alcohol use, and drug use; (2) identify correlates of psychosocial syndemics; and (3) examine the independent associations between psychosocial syndemic factors and sexual risk practices.
We used latent class analysis and a sample of 14,762 U.S. high school students who participated in the 2017 Youth Risk Behavior Surveillance System to examine youth population profiles based on shared characteristics of syndemics. Adjusting for sociodemographic factors, we conducted logistic regression to explore the connections between psychosocial syndemic factors and three sexual risk practices, namely, early initiation of sexual intercourse, condom use, and sex with multiple partners.
The study results indicate that three classes of risk exist among the sample: substance misuse (class 1, n = 3872, 26.2%), normative (class 2, n = 8791, 59.6%), and mental health problems (class 3, n = 2099, 14.2%). Class membership of psychosocial syndemics was significantly different by gender, age group, and race. The odds of initiating sexual intercourse before age 13 were positively associated with participants belonging in the substance misuse class and the mental health problem class. The odds of using condoms during the last sexual intercourse for currently sexually active adolescents were lower for participants classified in the substance misuse class. The likelihood of reporting having sex with four or more partners in a lifetime was higher among participants belonging to the substance misuse class.
The study advances our understanding of the heterogeneity of class membership associated with psychosocial syndemic risk factors among adolescents and extends our understanding of syndemics in the area of adolescent health. Thus, practitioners and policymakers can design multicomponent and multilevel school-based HIV/STI prevention programs that meet the needs of adolescents.
本研究旨在（1）基于抑郁和自杀意念等心理因素以及暴饮、饮酒和吸毒等社会因素，识别美国青少年中的心理社会综合征类型；（2）识别心理社会综合征的相关因素；（3）研究心理社会综合征因素与性风险行为之间的独立关联。
我们使用潜在类别分析，并以14762名参与2017年青少年风险行为监测系统的美国高中生为样本，根据综合征的共同特征来研究青少年人群概况。在对社会人口学因素进行调整后，我们进行逻辑回归，以探索心理社会综合征因素与三种性风险行为之间的联系，这三种性风险行为分别是过早开始性行为、使用避孕套以及与多个性伴侣发生性行为。
研究结果表明，样本中存在三类风险：物质滥用（第1类，n = 3872，26.2%）、正常（第2类，n = 8791，59.6%）和心理健康问题（第3类，n = 2099，14.2%）。心理社会综合征的类别归属在性别、年龄组和种族方面存在显著差异。13岁之前开始性行为的几率与属于物质滥用类别和心理健康问题类别的参与者呈正相关。对于目前有性行为的青少年，在最近一次性行为中使用避孕套的几率在被归类为物质滥用类别的参与者中较低。在属于物质滥用类别的参与者中，报告一生中有过四个或更多性伴侣的可能性更高。
该研究增进了我们对青少年中与心理社会综合征风险因素相关的类别归属异质性的理解，并扩展了我们对青少年健康领域综合征的理解。因此，从业者和政策制定者可以设计出满足青少年需求的多成分、多层次的基于学校的艾滋病毒/性传播感染预防项目。
