In the Journals

Black teens with mental illnesses at increased risk for HIV, STIs

For black teenagers, who account for 63% of new adolescent HIV cases in the United States, education on proper coping mechanisms targeting depression, emotion regulation and sexual risk behaviors may reduce their risk for sexually transmitted infections.

“The Substance Abuse and Mental Health Services Administration — SAMHSA — estimates that 2.8 million adolescents experienced a major depressive episode in the past year,” Bridgette M. Brawner, PhD, APRN, assistant professor of nursing in the department of family and community health at the University of Pennsylvania School of Nursing, and colleagues wrote. “In both clinical and non-clinical samples, heterosexually active black adolescents dealing with depressive symptomology may be less likely to use condoms, and even if condoms are used, to use them incorrectly.”

Bridgette M. Brawner

Researchers added that “they may be more likely to have sex under the influence of substances, be involved in dating violence, maintain simultaneous male and female partnerships and have sex in exchange for money, drugs and goods. Lifetime histories of STIs and pregnancies are also higher in this demographic.”

To compose the best strategies for targeted HIV and STI prevention, researchers first examined the risk factors associated with acquiring these diseases in black heterosexually active adolescents with mental illnesses between the ages of 14 and 17. Both boys and girls who received outpatient mental health care from programs in Philadelphia were included in this study, which included a computer-assisted personalized interview to assess sociodemographic information, sexual behaviors and emotion regulation.  

The researchers then determined the differences related to gender and relationship status using two sample t-tests, Wilcoxon Rank Sum tests and regression modeling.

For both black boys and girls, the percentage of adolescents with sexual partner concurrency while in a relationship (67.3%) and those who had multiple partners within the same day (42.3%) were significant, although boys tended to demonstrate more risk behaviors.

Those with sadness dysregulation were most likely to be in a current relationship and older age at first oral sex. Adolescents with increasingly severe depression were less likely to have unprotected oral sexual encounters in the past 3 months and were of older age at first vaginal sex. Both demographics were more likely to have fewer partners with whom they were having vaginal sex.

Despite this information, those without effective coping skills were more likely to have an increased number of vaginal and oral sexual partners and were younger when they first had vaginal sex.

“Blacks, adolescents and people with mental illnesses are all disproportionately affected by HIV/STIs,” Brawner said in a press release. “We know that the unique psychopathology of mental illness, including impulsivity and engaging in unprotected sex to alleviate depressed mood, may heighten one’s HIV/STI risk. Our study indicates we need to better understand unique HIV/STI prevention needs among black adolescents with mental illnesses and that improving coping mechanisms to help regulate emotion should be addressed in HIV/STI prevention research.” by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures or conflicts of interest.

For black teenagers, who account for 63% of new adolescent HIV cases in the United States, education on proper coping mechanisms targeting depression, emotion regulation and sexual risk behaviors may reduce their risk for sexually transmitted infections.

“The Substance Abuse and Mental Health Services Administration — SAMHSA — estimates that 2.8 million adolescents experienced a major depressive episode in the past year,” Bridgette M. Brawner, PhD, APRN, assistant professor of nursing in the department of family and community health at the University of Pennsylvania School of Nursing, and colleagues wrote. “In both clinical and non-clinical samples, heterosexually active black adolescents dealing with depressive symptomology may be less likely to use condoms, and even if condoms are used, to use them incorrectly.”

Bridgette M. Brawner

Researchers added that “they may be more likely to have sex under the influence of substances, be involved in dating violence, maintain simultaneous male and female partnerships and have sex in exchange for money, drugs and goods. Lifetime histories of STIs and pregnancies are also higher in this demographic.”

To compose the best strategies for targeted HIV and STI prevention, researchers first examined the risk factors associated with acquiring these diseases in black heterosexually active adolescents with mental illnesses between the ages of 14 and 17. Both boys and girls who received outpatient mental health care from programs in Philadelphia were included in this study, which included a computer-assisted personalized interview to assess sociodemographic information, sexual behaviors and emotion regulation.  

The researchers then determined the differences related to gender and relationship status using two sample t-tests, Wilcoxon Rank Sum tests and regression modeling.

For both black boys and girls, the percentage of adolescents with sexual partner concurrency while in a relationship (67.3%) and those who had multiple partners within the same day (42.3%) were significant, although boys tended to demonstrate more risk behaviors.

Those with sadness dysregulation were most likely to be in a current relationship and older age at first oral sex. Adolescents with increasingly severe depression were less likely to have unprotected oral sexual encounters in the past 3 months and were of older age at first vaginal sex. Both demographics were more likely to have fewer partners with whom they were having vaginal sex.

Despite this information, those without effective coping skills were more likely to have an increased number of vaginal and oral sexual partners and were younger when they first had vaginal sex.

“Blacks, adolescents and people with mental illnesses are all disproportionately affected by HIV/STIs,” Brawner said in a press release. “We know that the unique psychopathology of mental illness, including impulsivity and engaging in unprotected sex to alleviate depressed mood, may heighten one’s HIV/STI risk. Our study indicates we need to better understand unique HIV/STI prevention needs among black adolescents with mental illnesses and that improving coping mechanisms to help regulate emotion should be addressed in HIV/STI prevention research.” by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures or conflicts of interest.