Depressive Symptoms and Sexual Risk Behavior in Young, Chlamydia-Infected, Heterosexual Dyads
Received 3 July 2008; accepted 25 November 2008. published online 20 February 2009.
Abstract
Purpose
To examine associations between depressive symptoms and dyad-level sexual risk behavior in young heterosexual dyads with sexually transmitted infection (STI).
Methods
Chlamydia-positive 14–24-year-old, heterosexually active outpatients and their opposite-sex partners completed an assessment that included demographics, past and recent STI risk behaviors, and the Beck Depression Inventory (BDI). Participants in the top 25% of BDI scores within gender were categorized as depressed. Variables were created to identify dyads in which the female or male partner was depressed, as well as a measure of concordance of depression between partners. Dyad-level STI risk variables were created from the STI risk characteristics reported by each dyad member, and associations between these and the depression variables were analyzed.
Results
The 130 dyads were comprised of young men and women at high STI risk. One-third of dyads had at least one depressed partner. Dyads in which the female partner was depressed had greater partner age difference, greater total number of lifetime partners, and one or more partners reporting substance use within 2hours before sex, compared with dyads in which the female partner was not depressed. Dyads in which the male partner was depressed were more likely than the nondepressed-male dyads to report substance use before sex. All dyads in which both partners were depressed reported substance use before sex.
Conclusions
In young, chlamydia-infected, heterosexual dyads, depressive symptoms, especially in women, is related to increased dyad-level STI risk, including greater partner age difference, more partners, and substance use before sex.
aDivision of Adolescent/Young Adult Medicine, Children's Hospital Boston, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
bBureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, New York, New York and Division of Sexually Transmitted Disease, US Centers for Disease Control and Prevention, Atlanta, Georgia
cInstitute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts
dDivision of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts
eDepartments of Medicine, Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana
fRural Clinical Division, School of Medicine, University of Queensland, Australia
gDepartment of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana
Address correspondence to: Lydia A. Shrier, M.D., M.P.H., Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115.
Peter A. Rice, M.D., was formerly of the Section of Infectious Diseases, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts. Phillip G. Braslins, M.D., F.R.A.C.P., M.P.H.T.M., was formerly of the Section of Infectious Diseases, Boston University Medical Center and Boston University School of Medicine, Boston, Massachusetts.
ABSTRACT