INDIANAPOLIS – Adolescent women at high risk for acquiring sexually transmitted infections may not respond well to counseling and prevention efforts that focus on the fear of becoming infected, according to a study by researchers at Indiana University in Indianapolis.
Instead, programs and physicians may need to tailor their pregnancy and sexually transmitted infection (STI) counseling to recent patterns of sexual behavior, said Dr. Mary A. Ott of the university's section of adolescent medicine.
“Physicians should be aware that fear related to being infected influences sexual behavior only in the short term, and therefore should focus on interpersonal and relationship factors to influence long-term decisions about sex and abstinence,” Dr. Ott said at the annual meeting of the Midwest Society for Pediatric Research.
This urban study of 378 high-risk women aged 14–18 years indicated that the decision to have sex after a period of abstinence was strongly influenced by the relationship between the woman and the man she was involved with, as well as by sexual interest and mood, Dr. Ott explained, adding that this challenges the popular notion that adolescent sex is largely casual and lacking in personal commitment and caring.
The cohort of young women completed quarterly face-to-face interviews and two 3-month daily diary collections per year, and were followed up for a maximum of 4.5 years.
Periods of abstinence were defined as consecutive days of no vaginal sex as recorded in the daily diary. At the time of the study, 9% of the women had an active STI.
The study cohort had more than 6,000 periods of abstinence, of which 55% ended in sex. The median length of abstinence was 10 days, and the mean length was 39 days.
“Each year increase in a participant's age increased the hazard of ending an abstinence period with sex by 22%,” Dr. Ott said.
“For interpersonal influences, each unit increase in positive mood increased the hazard by 2%, each unit increase in negative mood decreased the hazard by 1%, and each unit increase in sexual interest raised the hazard by 22%,” Dr. Ott said.
With regard to interpersonal influences, each unit increase in partner support raised the hazard of having sex by 25%, and each unit increase in relationship quality raised the hazard by 5%.
A recent STI decreased the hazard of having sex and stopping a period of abstinence by 17%, she said.