Stress, Depressive Symptoms, Coping & Risky Sexual Behavior among Adolescents: Findings from the National Longitudinal Study of Adolescentto Adult Health (Add Health)

Introduction: The purpose of this study was to examine how adolescents' reports of stressful life events, depressive symptoms, and coping were related with their sexual risk behaviors. Methods: This study used data from waves 1 and 2 (ages 13-20 years, N=3,884) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative longitudinal data set of 7th-through 12th-grade students in the US collected between 1994 and 2009. Results: For female participants, reports of stressful life events predicted having a positive history of STIs (aOR = 2.16, 95% CI 1.87-2.50), contraceptive nonuse at last sexual intercourse (aOR = 1.18, 95% CI 1.03-1.34) and frequency of sexual acts (aOR = 1.53, 95% CI 1.39-1.69) after controlling for age, race/ethnicity and socioeconomic status. Additionally, for males, higher levels of stressful life events predicted reporting a history of STI (aOR = 2.01, 95% CI 1.83-2.46), nonuse of contraception (aOR = 1.23, 95% CI 1.07-1.43), and frequency of sexual intercourse (aOR = 1.33, 95% CI 1.23-1.46). Lack of effective coping was related to a greater risk of contraceptive nonuse at last sexual intercourse among females (aOR = 1.08, 95% CI 1.10-1.16) and males (aOR = 1.16, CI 1.06-1.26). Discussion: Findings indicate that stressful life events are significantly associated with increased sexual risk behaviors in both females and males. Among females, higher reports of stressful life events predicted greater odds of STI history, nonuse of contraceptives, and more frequent sexual activity, even after adjusting for age, race/ethnicity and socioeconomic status. Similarly, males experiencing more stressful events also reported higher rates of STI history, contraceptive nonuse, and sexual activity. Additionally, lack of effective coping skills further heightened the risk of contraceptive nonuse in both groups. Conclusion: These findings suggest that interventions targeting stressful life events should be considered as a component of programs aimed at reducing sexual risk behaviors among adolescents.