Consortium for Families and Health Research, University of Utah, 380 S 1530 E, Salt Lake City, UT, 84112, USA.
Department of Psychology, University of Utah, Salt Lake City, UT, USA.
Arch Sex Behav. 2021 Jan;50(1):205-217. doi: 10.1007/s10508-020-01747-2. Epub 2020 May 27.
This study investigated the influence of illness on sexual risk behavior in adolescence and the transition to adulthood, both directly and through moderation of the impact of social disadvantage. We hypothesized positive effects for social disadvantages and illness on sexual risk behavior, consistent with the development of faster life history strategies among young people facing greater life adversity. Using the first two waves of the National Longitudinal Study of Adolescent to Adult Health, we developed a mixed-effects multinomial logistic regression model predicting sexual risk behavior in three comparisons: risky nonmonogamous sex versus safer nonmonogamous sex, versus monogamous sex, and versus being sexually inactive, by social characteristics, illness, interactions thereof, and control covariates. Multiple imputation was used to address a modest amount of missing data. Subjects reporting higher levels of illness had lower odds of having safer nonmonogamous sex (OR = 0.84, p < .001), monogamous sex (OR = 0.82, p < .001), and being sexually inactive (OR = 0.74, p < .001) versus risky nonmonogamous sex, relative to subjects in better health. Illness significantly moderated the sex (OR = 0.88, p < .01), race/ethnicity (e.g., OR = 1.21, p < .001), and childhood SES (OR = 0.94; p < .01) effects for the sexually inactive versus risky nonmonogamous sex comparison. Substantive findings were generally robust across waves and in sensitivity analyses. These findings offer general support for the predictions of life history theory. Illness and various social disadvantages are associated with increased sexual risk behavior in adolescence and the transition to adulthood. Further, analyses indicate that the buffering effects of several protective social statuses against sexual risk-taking are substantially eroded by illness.
这项研究调查了疾病对青少年和成年过渡期性风险行为的直接影响，以及通过调节社会劣势的影响来调节这种影响。我们假设社会劣势和疾病对性风险行为有积极影响，这与面临更大生活逆境的年轻人更快地发展生活史策略的观点一致。我们使用全国青少年纵向成人健康研究的前两个波次，开发了一个混合效应多项逻辑回归模型，通过社会特征、疾病、二者的相互作用以及控制协变量，预测三种性风险行为比较：危险的非一夫一妻制性行为与更安全的非一夫一妻制性行为、一夫一妻制性行为以及无性行为。采用多项插补法处理少量缺失数据。报告疾病水平较高的受试者更不可能有更安全的非一夫一妻制性行为（OR=0.84，p<.001）、一夫一妻制性行为（OR=0.82，p<.001）和无性行为（OR=0.74，p<.001），与更健康的受试者相比，有风险的非一夫一妻制性行为。疾病显著调节了性（OR=0.88，p<.01）、种族/民族（例如，OR=1.21，p<.001）和童年 SES（OR=0.94；p<.01）对无性行为与危险的非一夫一妻制性行为比较的影响。实质性发现总体上在各波次和敏感性分析中都是稳健的。这些发现为生活史理论的预测提供了普遍支持。疾病和各种社会劣势与青少年和成年过渡期的性风险行为增加有关。此外，分析表明，几种保护社会地位对性冒险的缓冲作用因疾病而大大削弱。
