Psychological distress as a correlate of a biologically confirmed STI, risky sexual practices, self-efficacy and communication with male sex partners in African-American female adolescents.

Previous research has established the association between psychosocial factors and risky sexual behaviour. However, few studies have examined the relationship between psychological distress and sexually transmitted infection (STI)/HIV-associated behaviours in African-American youth. The present study examined the association of psychological distress with STI/HIV-risk behaviour and psycho-social mediators of HIV-preventive behaviours. A sample of 715 African-American female adolescents, 15-21 years old, completed an audio computer assisted self-interviewing (ACASI) assessing sociodemographics, psychological distress, self-efficacy, communication and STI/HIV-associated sexual behaviours. Participants also provided self-collected vaginal swab specimens, which were assayed for STIs. High levels of psychological distress were defined as having a score of > or =7 on the eight-item Centre for Epidemiological Studies-Depression Scale. The overall prevalence of high levels of psychological distress was 44.5%. Logistic regression analyses revealed that adolescents with high psychological distress, relative to those with low psychological distress, were more likely to have a biologically confirmed STI (adjusted odd ratio (AOR) = 1.40), use condoms inconsistently (AOR = 1.50), not use condoms during their last casual sexual encounter (AOR = 1.89), have sex while high on alcohol or drugs (AOR = 1.47), have male sexual partners with concurrent female sexual partners (AOR = 1.98), have low condom use self-efficacy (AOR = 1.54), partner sexual communication self-efficacy (AOR = 1.77), refusal self-efficacy (AOR = 2.05) and be more fearful of communicating with their partners (AOR = 1.98). These findings, although preliminary, could be used to inform HIV intervention programs and physicians/clinicians providing regular health care maintenance to African-American female adolescents engaging in risky sexual behaviour.