Depression, Sexually Transmitted Infection, and Sexual Risk Behavior among Young Adults in the United States MR Khan, JS Kaufman, BW Pence, BN Gaynes,

Slides:

Advertisements

Similar presentations

STD/HIV Risk from Adolescence to Adulthood: Longitudinal Risk Behavior Patterns and Infection Status Denise Hallfors, Bonita Iritani, Daniel Bauer, Carolyn.

Advertisements

STD Risk Behaviors of Incarcerated Youth Angela Robertson and Connie Baird-Thomas Mississippi State University This work was funded by the National Institute.

Repeat Infections among Adolescents and Young Adults: Findings From Philadelphia STD Clinics Nicole Liddon, PhD 1 Michael Eberhart, BS 2 Jami Leichliter,

Is Caregiver Depression Associated with Children’s ADHD Symptoms and Overall Functioning? Randi Scott SUMR Final Presentation August 07, 2008.

Predictors of Change in HIV Risk Factors for Adolescents Admitted to Substance Abuse Treatment Passetti, L. L., Garner, B. R., Funk, R., Godley, S. H.,

Influences of Marijuana Use on Adolescent HIV/STI Acquisition and Care Jonathan M. Ellen, MD Johns Hopkins School of Medicine.

Associations between Obesity and Depression by Race/Ethnicity and Education among Women: Results from the National Health and Nutrition Examination Survey,

Assay Results vs. Self-reported Chlamydial Infections: Does Measurement Discrepancy Vary by Level of Risk Behavior? Bonita Iritani, 1 Denise Hallfors,

Syphilis and HIV screening initiatives in North Carolina jails Lynne A. Sampson PhD, MPH HIV/STD Update September 25, 2008.

Factors Related to Adolescent Alcohol Use Progression Matos TD, Robles RR, Reyes JC, Calderón J, Colón HM, Negrón-Ayala JL CENTER FOR ADDICTION STUDIES,

Risk factors for Incident Trichomonas vaginalis among Women Recruited in RESPECT-2, an HIV Prevention Trial D Helms 1, D Mosure 1, T Peterman 1, C Metcalf.

The Internet: An Emerging Venue for Syphilis Epidemics Among Men Who Have Sex with Men in Los Angeles LAC - DHS Getahun Aynalem, MD, MPH, Kellie Hawkins,

RTI International is a trade name of Research Triangle Institute Untreated chlamydial infection among adolescents and young adults in Baltimore,

High Prevalence of Sexual Minority Status in a Sample of Women at High Risk for HIV Infection: Associated Individual-level Factors and Sexual Risk Behaviors.

Do Sex and Drug Behavior Patterns Account for HIV/STD Racial Disparities? May 8, 2007 Denise Hallfors, Ph.D. Bonita Iritani, M.A.

Typologies of Alcohol Dependent Cocaine-using Women Enrolled in a Community-based HIV Intervention Victoria A. Osborne, Ph.D., MSW*, Linda B. Cottler,

Trajectories of Sexual Risk Behavior in Adolescence and the Transition to Adulthood Marc A. Zimmerman School of Public Health University of Michigan Stevenson.

Anticipated Risk Compensation with Pre-Exposure Prophylaxis Use among North American Men who have Sex with Men Using an Internet Social Network D Krakower,

Developmental Trajectories of Adolescent Romantic Relationships, Sexual Behaviors, and Feelings of Depression University of Tennessee Catherine M. Grello.

The Relationship Between Psychotropic Medication Use and STI Infections Among Detained Youth Dexter R. Voisin Professor.

Housing Status and HIV Risk Behaviors Among Homeless and Housed Persons with HIV in the United States The findings and conclusions in this presentation.

Experience of Childhood Abuse and STI Prevalence Among Young Ukrainian Women Annie Dude University of Chicago American Public Health.

Background  Substance abusers are at risk for HIV and other STIs.  Anal intercourse (AI) is riskier than vaginal intercourse.  Studies of AI have focused.

Medication Adherence and Substance Abuse Predict 18-Month Recidivism among Mental Health Jail Diversion Program Clients Elizabeth N. Burris 1, Evan M.

Behavioral Health and HIV/HCV Risk Behavior Among Young African American IDUs Patricia M Morse, LCSW, PhD, Edward V, Morse, PhD, Samuel Burgess, MA, MPH.

138 th American Public Health Association Annual Meeting Denver, Colorado November 8, 2010 Determinants of HIV Testing Among High School Students with.

Sexual Behavior and Sexually Transmitted Infections in a Probability Sample of Adolescents in Baltimore, MD E. Eggleston 1, S.M. Rogers 1, C.F. Turner.

Associations Between Recent Gender- Based Violence and Pregnancy, Sexually Transmitted Infections, Condom Use Practices, and Negotiation of Sexual Practices.

Rodney C. Perkins 1, Grace K. Douglass 2, Victoria C. Ta 2, Aurnell Dright 1, Michael Fomundam 2, Ying Li 3, Michael Plankey 3 Sexually Transmitted Infection.

Differences between undiagnosed, HIV-positive and HIV-negative Black transgender women in the United States: Results from POWER Presented by Leigh A. Bukowski,

Condom Use and Anal Intercourse in Heterosexual Men and Women Kimberly R. McBride, Ph.D. 1,2,3 Erick Janssen, Ph.D. 2,4 1 Department of Pediatrics, Section.

Correlates of Never Using Condoms for Oral Sex Sara K. Head, MPH 1 Richard A. Crosby, PhD 1 Gregory Moore, MD 1 Adewale Troutman, MD 2 1 University of.

Seeking HIV-testing Only: Missed Opportunity for HIV Prevention?

Prevalence of Chronic Bronchitis in First Nations People Punam Pahwa,1, 2,* Chandima P. Karunanayake,1 Donna Rennie, 1 Kathleen McMullin,1 Josh Lawson,1.

J. Mossong1, N. Majéry2, C. Mardaga3 , M. Muller4, F. Schneider1

Nation’s First Collaborative School of Public Health

Attachment style and condom use across and within dating relationships

Kimberly Jeffries Leonard, Ph.D.

Gender disparities in self-reported fear of an intimate partner

Pengjun Lu, PhD, MPH;1 Kathy Byrd, MD, MPH;2

Joanne Pavao, MPH Study for Health & Employment

Maria Cabrera Escobar Nkosinathi Ngcobo & Timothy Quinlan

Prevalence of Sexually Transmitted Infections and Bacterial Vaginosis among Female Adolescents in the United States: Data from the National Health and.

Mesfin S. Mulatu, Ph.D., M.P.H. The MayaTech Corporation

Psychosocial and behavioral predictors of partner notification for STD and HIV exposure among MSM Matthew J. Mimiaga, ScD, MPH, Sari L. Reisner, MA,

Daniulaityte, R., Falck, R., & Carlson, R. Introduction

HIV-1 and STIs Prevalence and Risk Factors among Miners and Female Sex Workers in the Mining Areas of Gejiu, Yunnan, China Ding Guowei, M.D., M.S. National.

Disparities in process and outcome measures among adults with persistent asthma David M. Mosen, PhD, MPH; Michael Schatz, MD, MS; Rachel Gold, PhD; Winston.

Rabia Khalaila, RN, MPH, PHD Director, Department of Nursing

Physical assault partially mediates the impact of transgender status on depression and poly- substance use among Black transgender women in the United.

Kristen Williams, Jonathan J.K. Stoltman, and Mark K. Greenwald

Associations between Depression and Obesity: Findings from the National Health and Nutrition Examination Survey, Arlene Keddie, Ph.D. Assistant.

Objective: To examine the relationship between exposure to violence and HIV/HCV high risk-behaviors in a cohort of young African-American IDUs. Of particular.

Table 1: NHBS HET3 Participant Characteristics

H azardous Drinking, Drinking Expectancies And Risky Sexual Behaviors In A Community Sample Of Adult Sexual Minority Women 33rd Annual Research.

HIV prevalence and sexual behavioral roles among Men who have sex with men (MSM) in Nigeria T. Badru , O. Adedokun, E. Oladele , O. Adebayo , H. Khamofu.

Introduction Results Hypotheses Discussion Method

A study of high risk African American women, 15 to 21 years of age

STIs in a multi-site sample of high-risk, substance-using MSM:

The Relationship between Recent Alcohol Use and Sexual Behaviors/STDs: Gender Differences among STD Clinic Patients Heidi E. Hutton PhD, Mary E. McCaul.

Poster WP41; Contact: David A. Katz,

Epidemiology of exercise and physical activity

VACS Scientific Meeting Houston, TX February 2004

M Javanbakht, S Guerry, LV Smith, P Kerndt

CONCLUSIONS & IMPLICATIONS

Finding Sex Partners On-Line: What’s the Risk for STI

Types of questions TVEM can answer

JS Leichliter,1 FR Bloom,1 SD Rhodes2

Arely M. Hurtado1,2, Phillip D. Akutsu2, & Deanna L. Stammer1

Kyle T. Bernstein, Katherine Ahrens, Susan S. Philip, Jeffrey D

Presentation transcript:

Depression, Sexually Transmitted Infection, and Sexual Risk Behavior among Young Adults in the United States MR Khan, JS Kaufman, BW Pence, BN Gaynes, AA Adimora, SS Weir, WC Miller National Development & Research Institutes, NY, NY University of North Carolina, Chapel Hill, NC Duke University, Durham, NC 2008 National STD Prevention Conference – Chicago, IL March 13, 2008

Depression and STI or Related Sexual Risk Behaviors Depression associated with 1.5 - 4 odds of: STI (Ramrakha S. 2000, Shrier L. 2001) Multiple partnerships (Kosunen E. 2003) Unprotected sex (Ramrakha S. 2000) Early onset of sex (Kaltiala-Heino R. 2003, Hutton H. 2004) Depression inconsistent predictor of STI Nationally-representative adolescent sample (Shrier L. 2002) Depressed boys had >3 times levels of STI one year later Depressed girls did not have higher STI levels Baltimore sample of drug users (Williams C. 2005) Depression associated with modest increases in STI

Depression and STI: Theory Disrupted self-regulation Maladaptive behaviors Emotional reactivity in relationships ? ? Substance Use ? Sexual risk behavior & STI References: Aseltine 1994, Crepaz 2001, Beck 2003, Rao 2006

Methods

The National Longitudinal Study of Adolescent Health (Add Health) Prospective cohort study Nationally-representative Wave I (1995) In-home questionnaire (N=20,724) Wave III (2001-02) In-home questionnaire (N=14, 322) Bio-specimen collected and testing for Chlamydia trachomatis, Neisseria gonorrhea, or Trichomonas vaginalis

Current Study: Aim & Sub-Population Depression Timing and Duration (Wave I, III) Biologically-confirmed STI Multiple sexual partnerships Inadequate condom use (Wave III) Analytic sample: Complete sample weight variables Non-missing STI data & depression data N = 2298 black/Latina women N = 1970 black/Latino men N = 3337 white women N = 2940 white men

Exposure Assessment (1) Center for Epidemiologic Studies (CES-D) Modified scale = 9 items measure symptoms past week Identified cut-point for symptoms suggestive of major depression Calculated depression score for: Adolescence (Wave I) Adulthood (Wave III) Identified if respondent had depression in adolescence, adulthood, or both

Exposure Assessment (2) Depression timing and duration Chronic Depression in adolescence (Wave I) & adulthood (Wave III) Recent Depression in adulthood only (Waves III) Prior Depression in adolescence only (Wave I only) None Depression history (neither Wave I, nor Wave III)

Outcome Assessment 1. Wave III biologically-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhea, or Trichomonas vaginalis (yes versus no) 2. Multiple partnerships (past year) 3. Never used condom during sex (past year)

Stratification Variables 1. Gender (men versus women) 2. Race/ethnicity (white versus black/Latino)

Multivariable Modeling Exposure: Depression Outcomes: STI & sexual risk behaviors Stratification variables: Gender, race/ethnicity Gender-specific logistic regression for survey data Depression*minority interaction term Unadjusted OR: Depression and STI/risk behavior Adjusted ORs: Depression and STI Respondent adolescent STI status (Wave I) Respondent age Socio-economic indicators: Respondent income, mother’s education Confounding by substance use explored

Results

Adult STI (Wave III) by Race/ethnicity Overall STI Prevalence: 6% % STI Black/Latina women 16% Black/Latino men 12% White women 4% White men 3%

Depression in Adolescence (Wave I) and Adulthood (Wave III) by Race/ethnicity MDD Timing and Duration Prior depression (Wave I only) 12% Recent depression (Wave III only) 7% Chronic depression (Waves I & III) 5% Total: Ever had depression 24% Black/Latina women: 36% Black/Latino men: 24% White women: 27% White men: 16%

Black/Latina Women: Depression & Adult STI Adjusted for Socio-demographics & Adolescent STI Prior Depression Recent Depression Chronic Depression Odds Ratio Further adjustment for substance use in adolescence: OR=1.4, 95% CI: 0.8-2.3

Multiple Partnerships Never Used Condoms During Sex Black/Latina Women: Depression & Adult Sexual Risk Behaviors Unadjusted Multiple Partnerships Never Used Condoms During Sex Prior Dep Recent Dep Chronic Dep Prior Dep Recent Dep Chronic Dep Odds Ratio

Black/Latino Men: Depression & Adult STI Adjusted for Socio-demographics & Adolescent STI Prior Depression Recent Depression Chronic Depression Odds Ratio Further adjustment for substance use in adolescence: OR=2.1, 95% CI: 1.0-4.7

Black/Latino Men: Depression & Adult Sexual Risk Behaviors Unadjusted Multiple Partnerships Never Used Condoms During Sex Prior Dep Recent Dep Chronic Dep Prior Dep Recent Dep Chronic Dep Odds Ratio

White Women: Depression & Adult STI Adjusted for Socio-demographics & Adolescent STI Prior Depression Recent Depression Chronic Depression Odds Ratio

White Women: Depression & Adult Sexual Risk Behaviors Unadjusted Multiple Partnerships Never Used Condoms During Sex Prior Dep Recent Dep Chronic Dep Prior Dep Recent Dep Chronic Dep Odds Ratio

White Men: Depression & Adult STI Adjusted for Socio-demographics & Baseline STI Prior Depression Recent Depression Chronic Depression Odds Ratio

Add Health Summary & Public Health Implications (1) Depression STI among minorities Strongest associations between depression and STI Minority men: Chronic depression Minority women: Adolescent depression Low condom use likely contributes to STI among depressed Race differential in STI diagnosis and treatment Integration of programs for mental health, substance use, and STI needed Minorities communities should be prioritized

Add Health Summary & Public Health Implications (2) Depression Sexual behaviors among white women Sexual risk behavior did not translate to higher STI levels Potential for infection spread given risk behaviors

Limitations Unable to conduct a strictly longitudinal analysis Substance use – treated as a confounder but may be a mediating variable Depression measurement may not be sensitive, specific

Further Study Add Health Wave IV Chronic depression  Adulthood STI

Acknowledgements Behavioral Sciences Training in Drug Abuse Research Postdoctoral Fellowship Sponsors: Medical and Health Research Association of New York City and NDRI Funding: National Institute on Drug Abuse (NIDA Grant # 5T32 DA07233).