Cognitive and Behavioral Predictors of Sexually Transmitted Disease Risk Behavior Among Sexually Active Adolescents

Bearinger, Linda H.; Remafedi, Gary; Taylor, Barbara M.; Harmon, Brian

doi:10.1001/archpedi.1997.02170400029006

Cited by 85 publications

(31 citation statements)

References 25 publications

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“…However, compared to previous tests of cognitive-behavioral models with other teen populations, this study yielded similar levels of explained variance. Two earlier studies testing AIDS information, motivation, and behavioral skills explained 22% and 21% of the variance in adolescent STD risk (Boyer et al, 2000;Sieving et al, 1997), and Fisher et al (1999) reported that the IMB model accounted for 75% and 46% of the variance in AIDS-risk for male and female adolescents respectively. Moreover, with two exceptions (see Fisher, Fisher, Williams, & Malloy, 1994;Fisher et al, 1999), the outcome measures used in the current study were similar to those in other research.…”

Section: Discussionmentioning

confidence: 96%

Applying a Cognitive-Behavioral Model of HIV Risk to Youths in Psychiatric Care

Donenberg¹,

Emerson²,

Wilson³

et al. 2005

AIDS Education and Prevention

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This study examined the utility of cognitive and behavioral constructs (AIDS information, motivation, and behavioral skills) in explaining sexual risk taking among 172 12-20-year-old ethnically diverse urban youths in outpatient psychiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS information, motivation, and behavioral skills to risky sexual behavior among teens receiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors alone may not explain sexual risk taking among teens whose cognitive and emotional deficits (e.g., impaired judgment, poor reality testing, affect dysregulation) interfere with HIV preventive behavior. The most powerful explanatory model will likely include a combination of cognitive, behavioral, developmental, social (e.g., family), and personal (e.g., psychopathology) risk mechanisms.HIV continues to spread among young people despite a decreased incidence of AIDS cases nationwide. HIV infection doubles every 14 months in adolescents, and teenagers account for 25% of new sexually transmitted diseases (STDs) reported annually (Centers for Disease Control and Prevention, 2000). Teens are most likely to acquire HIV through risky sexual behavior (e.g., sex without a condom), but risk is not uniform across youths. Adolescents receiving mental health services are especially vulnerable to HIV because they engage in the same risk behaviors as their school-aged peers but at higher rates (Brown, Danovsky, Lourie, DiClemente, & Ponton, 1997;Donenberg, Emerson, Bryant, Wilson, & Weber-Shifrin, 2001). In a recent study, teens in psychiatric care reported high rates of unprotected sexual intercourse (55%), sex while using drugs/alcohol (49%), sex with a high-risk partner (43%), and being currently sexually active (45%) (Donenberg et al., 2001). Cognitive deficits associated with mental health problems, such as impaired decision making, poor judgment, impulsivity, and inaccurate assessment of risk exacerbate the health risks for these youths, but their unique risk mechanisms are not well understood. The current study tested a cognitivebehavioral model of HIV risk among youths in psychiatric care based on the constructs of the information-motivation-behavioral skills (IMB) model (Fisher & Fisher, 1992 THE INFORMATION-MOTIVATION-BEHAVIORAL SKILLS (IMB) MODELMost theories of health behavior implicate cognitive determinants of HIV risk and prevention, such as AIDS knowledge, personal attitudes, and behavioral intentions to practice prevention (Ajzen & Fishbein, 1980). Among these theories, the IMB model (Fisher & Fisher, 1992) stands out as an integrative framework to explain AIDS risk reduction. The IMB model posits two cognitive and one behavioral factor as determinants of AIDS prevention behavior: (a) information, o...

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Section: Discussionmentioning

confidence: 96%

Applying a Cognitive-Behavioral Model of HIV Risk to Youths in Psychiatric Care

Donenberg¹,

Emerson²,

Wilson³

et al. 2005

AIDS Education and Prevention

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“…21,22 The theoretically constructed composite measure of suicide risk behavior was comprised of responses to three items. To assess suicidal ideation, students were asked: "In the last month: I haven't had any thoughts about killing myself; I have had thoughts about killing myself, but I would not carry them out; or I would like to kill myself."…”

Section: Study Population and Measuresmentioning

confidence: 99%

Adolescent Sexual Aggression: Risk and Protective Factors

1997

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ABSTRACT. Objective. Little research addresses the correlates of sexual aggression in nonclinical populations of adolescents. The purpose of this study was to identify risk and protective factors associated with sexual violence among male and female adolescents.Methods. We analyzed data on 71 594 students in the 9th and 12th grades responding to the 1992 Minnesota Student Survey, an anonymous, self-report survey examining an array of risk environments, health-compromising behaviors, and protective factors. The responses of students reporting a history of forcing someone into a sexual act were compared with those who reported that they had never forced someone into a sexual act. Separate analyses were conducted for males and females.Results. A history of sexual violence perpetration was reported by 4.8% of male and 1.3% of female adolescents. Using a logistic regression model, sexual aggression was associated with experiencing intrafamilial or extrafamilial sexual abuse, witnessing family violence, frequent use of illegal drugs, anabolic steroid use, daily alcohol use, gang membership, high levels of suicide risk behavior, and excessive time spent "hanging out." Emotional health and connectedness with friends and adults in the community were protective factors for male adolescents against sexually aggressive behavior, and academic achievement was a protective factor for female adolescents.Conclusions. A history of forcing someone into a sexual act was associated with several risk and protective factors. Efforts to prevent adolescent sexual violence should target individuals at increased risk. Through their psychosocial assessment of young people, health care professionals can play a role in identifying, counseling, and making appropriate referrals for adolescents at risk for sexually aggressive behavior. Pediatrics 1997;100(6). URL: http://www.pediatrics.org/cgi/content/full/100/6/e7; adolescence, sexual aggression, violence, risk factors, protective factors.

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“…The outcome measure chosen refers to condom use at first intercourse with a new partner, because this is a high-risk situation for which protection is strongly recommended in all STI prevention campaigns. Furthermore, it has been found that risky sexual behaviors, once initiated, are resistant to change (Sieving et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Condom Use at First Intercourse with a New Partner in Female Adolescents and Young Adults: The Role of Cognitive Planning and Motives for Having Sex

2006

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This study examined the extent to which cognitive planning and motives for sex can explain condom use at first intercourse with young females' most recent partner. A total of 133 female adolescents completed a questionnaire on cognitive planning (i.e., mentally preparing oneself for discussing condom use and for managing condoms), motives for having sex (i.e., having sex to express love, to experience pleasure, to enhance mood, and to please others), and condom use at this particular occasion. Logistic regression analyses showed that condom use was positively related to cognitive planning with respect to discussing condom use and negatively related to the motive for having sex to enhance mood. Cognitive planning for the management of condoms did not have a significant overall effect on condom use, but it did appear to be very effective for those adolescents who had a low score on the motive for having sex to express love. It thus appears useful to strengthen the skills of adolescents to discuss the use of condoms. Furthermore, stressing the negative affective consequences of unsafe sex may be particularly effective for those who are inclined to have sex to enhance mood, while encouraging adolescents to make plans for the management of condoms is likely to positively affect the use of condoms among those who are not primarily motivated to express love by having sex.

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Cognitive and Behavioral Predictors of Sexually Transmitted Disease Risk Behavior Among Sexually Active Adolescents

Cited by 85 publications

References 25 publications

Applying a Cognitive-Behavioral Model of HIV Risk to Youths in Psychiatric Care

Applying a Cognitive-Behavioral Model of HIV Risk to Youths in Psychiatric Care

Adolescent Sexual Aggression: Risk and Protective Factors

Condom Use at First Intercourse with a New Partner in Female Adolescents and Young Adults: The Role of Cognitive Planning and Motives for Having Sex

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