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This study was conducted to investigate the association between psychiatric disorders and high-risk sexual behavior among adolescent primary care patients. Interviews assessing anxiety, conduct, depressive, eating, substance use, and personality disorders (PDs), as well as histories of sexual behavior were administered to 119 male and 284 female adolescent primary care patients. Results indicated that, after co-occurring psychiatric disorders were controlled statistically, adolescents with elevated PD symptom levels were more likely than adolescents without elevated PD symptom levels to report a high number of sexual partners during the past year and during their lifetime. Adolescents with a history of conduct disorder were more likely than adolescents without such a history to report a high number of lifetime unsafe sexual partners. Elevated antisocial, dependent, and paranoid PD symptom levels were associated with high-risk sexual behavior after co-occurring psychiatric disorders were controlled. Further, certain specific antisocial, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, and schizotypal PD symptoms were independently associated with high-risk sexual behavior after co-occurring psychiatric disorders and overall PD symptom levels were controlled. The association between overall PD symptom levels and the number of sexual partners was significantly stronger among the females than among the males in the sample. Increased recognition and treatment of PDs, coupled with increased recognition of high-risk sexual behavior may facilitate the prevention of sexually transmitted diseases and teenage pregnancy among adolescents.
High-risk sexual behavior among adolescents is a major public health problem in the United States. Current estimates suggest that 650,000 to 900,000 Americans are now living with human immunodeficiency virus (HIV). At least 40,000 new infections occur each year, and a large proportion of these cases are occurring among adolescents and young adults (Centers for Disease Control and Prevention [CDCP], 1998) Despite the fact that today's adolescents have reached sexual maturity with an awareness of HIV and acquired immunodeficiency syndrome (AIDS), risky sexual practices have been increasing within this cohort in recent years. In addition to vaginal sex, noncoital behaviors, such as oral and anal sex, are becoming common among teenagers (Remez, 2000). Sexually Transmitted Diseases (STDs) including syphilis, gonorrhea, and chlamydia have the highest growth rate among adolescents (Katz, Fromme, & D'Amico, 2000). Of the 12 million new STD cases reported each year, 25% occur among female adolescents. STDs...