Publication Abstract
Hall, Kelli Stidham, Yasamin Kusunoki, Heather Gatny, and Jennifer Barber. 2014. "Stress Symptoms and Frequency of Sexual Intercourse among Young Women." Journal of Sexual Medicine 11(8):1982-1990.
INTRODUCTION
We have previously documented the relationships between stress and depression symptoms and adolescent women's nonuse and misuse of condoms and other contraceptive methods and on their undesired pregnancy rates.
AIM
Here, we examine relationships between mental health symptoms and another understudied adolescent reproductive health behavior - frequency of sexual intercourse.
MAIN OUTCOME MEASURE
Our outcome was weekly sexual intercourse activity.
METHODS
We used panel data from a longitudinal, population-based cohort study of 992 women ages 18–20. Weekly journals measured sociodemographic, relationship, reproductive, and mental health characteristics, sexual and contraceptive behaviors, and pregnancy. We examined 27,130 surveys from 952 women during the first study year. Predictors of weekly sexual intercourse were moderate/severe stress (PSS-4) and depression (CESD-5) symptoms measured at baseline. Multi-level, mixed-effects logistic regression models estimated the relationships between stress and depression symptoms and the weekly odds of sexual intercourse while adjusting covariate fixed effects and random woman effects.
RESULTS
Nearly a quarter of the sample had moderate/severe stress (23%) and depression (24%) symptoms at baseline. Women reported sexual intercourse in 36% of weeks. Proportions of sexually active weeks were higher among women with stress (43%) and depression (40%) compared to those without symptoms (35% and 35%, respectively, p-values<0.001). Controlling for covariates, women with baseline stress symptoms had 1.6 times higher weekly odds of sexual intercourse compared to women without stress (aOR 1.6, CI 1.1–2.5, p=0.04). Depression symptoms were not associated with sexual intercourse frequency in adjusted models.
CONCLUSIONS
Stress symptoms were positively associated with sexual intercourse frequency among these young women. Research and practice efforts are needed to identify effective sexual health promotion and risk reduction strategies, including contraceptive education and counseling, in the context of mental health symptoms and undesired pregnancy.