The 130th Annual Meeting of APHA

Abstract #46051

Celia M. Lescano, PhD, Larry K. Brown, MD, Kristie L. Puster, PhD, and Heather L. Hunter, BA. School of Medicine, Brown University, Rhode Island Hospital, 593 Eddy Street-Middle House 201, Providence, RI 02903, 401-444-8539, CLescano@lifespan.org

Background: Research indicates that sexual risk behaviors are common in youth with various forms of psychopathology. The association with disturbances of conduct (externalizing disorders) has been demonstrated; however, disturbances of emotion (internalizing disorders) may also put adolescents at risk for HIV. This study examined associations between HIV risk and internalizing behaviors (e.g., self-cutting) among adolescents receiving mental health treatment. Methods: Fifty-six adolescents completed the Adolescent Risk Inventory, a brief measure designed to screen for sexual risk behaviors, emotional and behavioral symptoms (e.g., history of suicidal behaviors and IV drug use), and related attitudes (e.g., self-efficacy for condom use). Results: Seventy percent of adolescents reported being sexually active. Among those, 53% reported recent sex without a condom and 34% reported recent alcohol or drug use during sex. Sexual risk behavior was significantly correlated with emotional disturbance [r=.37, p< .01] and those who reported more emotional disturbance reported more sex risk [t=2.102, p=.04]. Sexually active adolescents who reported higher rates of internalizing behaviors were less likely to report intentions to use condoms in the next three months than those who reported fewer internalizing behaviors (92% vs. 42%; p=.01). Regression analyses revealed that, even controlling for all other factors, emotional or behavioral disturbance accounted for almost 10% of the variance in sex risk behaviors. Conclusions: Adolescents with behavioral or emotional difficulties are at increased risk for HIV. Clinicians should be aware that adolescents with disturbances of emotion are more likely to engage in sexual risk-taking behaviors than their non-distressed peers.

Learning Objectives:

• Define externalizing and internalziing behaviors in adolescents.
• Describe how externalizing and internalizing behaviors are associated with sexual risk.
• Discuss the importance of assessing the presence of externalizing and internailzing behaviors in the assessment of adolescent risk behavior.

Keywords: Adolescents, Sexual Risk Behavior

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.