The association between stress, coping, and sexual risk behaviors over 24 months among African-American female adolescents

Abstract

Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African-American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6, 12, 18, and 24 months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p = .018), inconsistent condom use (p = .011), and not using a condom at last sex (p = .002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population.

Keywords:

• stress
• coping
• sexual risk behavior
• HIV prevention intervention
• African-American adolescent women

Additional information

Funding

Funding. This work was supported by the National Institute of Mental Health [grant number 5R01 MH070537-08] to the senior author. Additional support was provided by the Emory Center for AIDS Research (P30 AI050409), the Atlanta Clinical & Translational Science Institute (UL1TR000454) and the Center for Contextual Genetics & Prevention (P03 DA027827). Andrea Swartzendruber was supported by National Institute on Alcohol Abuse and Alcoholism [grant number F32 AA022058]; and Jessica M. Sales was supported by the National Institute of Mental Health [grant number K01 MH085506].