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Cognitive and Behavioral Predictors of Sexually Transmitted Disease Risk Behavior Among Sexually Active Adolescents
Renee Sieving, PhD, MSN, RNC;
Michael D. Resnick, PhD;
Linda Bearinger, PhD, MS, BSN;
Gary Remafedi, MPH, MD;
Barbara A. Taylor, MPH, RN;
Brian Harmon
Arch Pediatr Adolesc Med. 1997;151(3):243-251.
Abstract
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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.
Arch Pediatr Adolesc Med. 1997;151:243-251
Author Affiliations
From the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, School of Medicine, and Graduate Studies in Adolescent Nursing, School of Nursing (Drs Sieving and Bearinger), Division of General Pediatrics and Adolescent Health, Department of Pediatrics, School of Medicine, and Division of Health Management and Policy, School of Public Health (Dr Resnick), and Division of General Pediatrics and Adolescent Health, Department of Pediatrics, School of Medicine (Dr Remafedi, Ms Taylor, and Mr Harmon), University of Minnesota, Minneapolis.
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