Association Between Psychiatric Disorders, Substance Use, and Sexual Risk Behaviors in Perinatally HIV-Exposed Youth.
Stephanie Benson, Katherine S Elkington, Cheng-Shiun Leu and 4 others
PMID 29526603WHAT IT FOUND
Substance use disorder and behavior disorders, not mood or anxiety disorders, were linked to sexual risk behaviors in perinatally HIV-exposed youth over time.
Key findings
01Youth with substance use disorder were significantly more likely to report ever having vaginal or anal sex than those without.
02Behavior disorder and substance use disorder were significantly associated with condomless sex in the previous 3 months.
03Mood and anxiety disorders were not significantly associated with sexual risk behaviors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is an observational cohort, so it cannot show that a disorder caused sexual risk or that treating it would reduce risk. Analyses came from later follow-ups after attrition: 280 of 340 enrolled dyads completed FU1, and 84% of originally enrolled participants were re-recruited. Condomless sex analyses included only sexually active participants, with small numbers at FU2 (n = 42) and FU4 (n = 118). The study did not separate condomless anal sex from vaginal sex because anal sex was infrequent. Few participants reported same-sex behavior, so differences by sexual orientation could not be examined. Number of sexual partners, sex education knowledge, and partner PrEP use were not examined. Psychiatric and substance use diagnoses relied on interviews and self-report, and some findings came from subgroup analyses by HIV status.
Declared interests
The supplied text does not include a conflict-of-interest or funding declaration. The publication type lists Research Support, N.I.H., Extramural.
The easy way to misread this
Do not conclude that treating substance use or behavior disorders reduces sexual risk. This is an observational cohort, so it shows associations, not a tested intervention. Do not assume perinatally infected youth are inherently riskier; rates of penetrative and condomless sex were similar between infected and exposed but uninfected youth.