Cognitive and behavioral predictors of sexually transmitted disease risk behavior among sexually active adolescents
R. Sieving, M. D. Resnick, L. Bearinger, G. Remafedi, B. A. Taylor and B. Harmon
Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, USA.
OBJECTIVE: To identify important cognitive and behavioral predictors of
sexually transmitted disease (STD) risk behavior among a sexually active
adolescent cohort. DESIGN: One-year longitudinal study of health beliefs,
sexual behaviors, and STD acquisition among 549 adolescents, 14 to 21 years
of age. SETTING: School- and community-based health clinics in a large
metropolitan area. PARTICIPANTS: Data from 410 sexually active adolescents
completing surveys at baseline and 1-year follow-up. INTERVENTIONS: None.
MAIN OUTCOME MEASURE: Sexually transmitted disease risk behavior--a
composite measure of condom use consistency with most recent sexual
partner(s), number of vaginal sex partners, and frequency of intercourse
with most recent sexual partner(s). RESULTS: For girls (n = 335), a model
including baseline STD risk behavior, condom use self-efficacy, oral
contraceptive use, communication with sexual partners about STD prevention,
and alcohol use in connection with sexual activity explained 21.1% of the
variance in STD risk behavior at 1-year follow-up. For boys (n = 75), the
strongest predictors of STD risk behavior at follow-up included baseline
STD risk behavior, perceived susceptibility to STD, condom use
self-efficacy, negative outcome expectations associated with condom use,
and perceived barriers to STD prevention. CONCLUSIONS: Efforts targeting
reduction in STD risk behavior must begin before the onset of somewhat
stable patterns of sexual risk behavior. Among adolescents who are sexually
active, interventions should include components that increase condom use
self-efficacy, build skills to communicate with sexual partners about STD
prevention, and address behaviors associated with STD risk behavior
including oral contraceptive use.
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