Abstract
Purpose
To better understand links between depressive symptoms and high-risk sexual behavior
in young women.
Methods
We conducted semistructured interviews with young women from three primary care clinics
who reported clinically significant depressive symptoms, had penile-vaginal sexual
intercourse within the past 6 months, and met at least one sexual risk criterion (N = 16,
age 16–23 years, racially/ethnically diverse). We transcribed the interview recordings, organized
and coded the data, and conducted a directed content analysis.
Results
Participants described a complex interrelation between depression and intimate relationships
and sexual behavior. Depression had negative effects on relationships, sexual motives
and experiences (including safety), and feelings about oneself in sexual situations.
Participants reported difficulty in developing and maintaining intimate relationships.
Although many participants reported less interest in and emotional energy for sex,
several were having sex frequently to manage depressive symptoms. Generally, the young
women described sex as unsafe (e.g., no condom) owing to impaired judgment, increased
impulsivity, apathy, and alcohol. As a result, sometimes their efforts to feel better
by having sex led them to feeling worse (e.g., ashamed and worthless).
Conclusions
Depressed young women may limit intimate relationships, yet engage in frequent and
unsafe sex to cope with their symptoms. Their efforts to feel better may provide only
temporary relief or result in feeling worse. Depressed young women would benefit from
tailored interventions that identify and counter unhealthy thoughts, attitudes, behaviors,
and patterns related to sexual relationships and behavior; minimize factors that impair
healthy decision-making; and foster development of alternative affect regulation strategies.
Keywords
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Article info
Publication history
Published online: August 14, 2018
Accepted:
May 8,
2018
Received in revised form:
May 5,
2018
Received:
January 17,
2018
Footnotes
Conflict of interest: Neither I nor my three co-authors have any potential conflict of interest, real or perceived.
Identification
Copyright
© 2018 Society for Adolescent Health and Medicine. All rights reserved.
