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Correlates of Continued Risky Sex Among Pregnant African American Teens: Implications for STD Prevention

CROSBY, RICHARD A. PhD*†; DiCLEMENTE, RALPH J. PhD*†‡; WINGOOD, GINA M. ScD, MPH*†; ROSE, EVE MPH*; LANG, DELIA PhD, MPH*

Sexually Transmitted Diseases: January 2003 - Volume 30 - Issue 1 - p 57-63
Article

Background African American adolescent females have been understudied with regard to their continued sexually transmitted disease (STD) risk behavior during pregnancy. Preintervention studies of this population are especially important because the sequelae of STDs during pregnancy can be particularly problematic.

Objective This exploratory study identified correlates of engaging in relatively frequent penile-vaginal sex, unprotected by a condom, among inner-city African American adolescents during their first or second trimester of pregnancy.

Study Design Baseline data collected as part of an HIV prevention study were used. Adolescents at their first prenatal visit completed a self-administered survey and face-to-face interview. Only adolescents reporting a current boyfriend were included in this exploratory analysis (n = 144). Significant bivariate correlates were assessed for multivariate significance.

Results Significant bivariate correlates of relatively frequent unprotected vaginal sex were older age (P < 0.02), primiparity (P < 0.03), not being enrolled in school (P < 0.02), not residing with at least one parent (P < 0.001), reported infrequent sexual communication (communicating about sex) with the boyfriend (P < 0.01), spending at least 30 hours each week with the boyfriend (P < 0.001), reporting that the age of the current relationship was at least 2 years (P < 0.04), and using marijuana in the past 30 days (P < 0.03). Three correlates retained significance in the multivariate model: not residing with at least one parent (adjusted odds ratio [AOR] = 2.24;P < 0.04), spending at least 30 hours with the boyfriend each week (AOR = 3.70;P < 0.002), and infrequent sexual communication with the boyfriend (AOR = 2.88;P < 0.008).

Conclusion Given the potential of STDs to complicate pregnancy outcomes, clinic-based and community-based programs addressing relational dynamics and relational obstacles to safer sex may be warranted, particularly for adolescents not residing with parents.

A study of pregnant adolescents identified three multivariate correlates of continued risky sex: not residing with parents, spending relatively more time with boyfriends, and infrequent sexual communication with boyfriends.

*Rollins School of Public Health, Department of Behavioral Sciences and Health Education; Emory Center for AIDS Research; and School of Medicine, Department of Pediatrics (Division of Infectious Diseases, Epidemiology and Immunology), Emory University, Atlanta, Georgia

Supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health (1R01 MH54412), and the Office of AIDS Research.

Reprint requests: Richard A. Crosby, PhD, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road NE, Room 542, Atlanta, GA 30322. E-mail: rcrosby@sph.emory.edu

Received for publication February 12, 2002,

revised April 19, 2002, and accepted May 6, 2002.

© Copyright 2003 American Sexually Transmitted Diseases Association