Correlates of continued risky sex among pregnant African American teens: Implications for STD prevention

Background: African American adolescent females have been understudied with regard to their continued sexually transmitted disease (STD) risk behavior during pregnancy. Preintervention studies of this population are especially important because the sequelae of STDs during pregnancy can be particularly problematic. Objective: This exploratory study identified correlates of engaging in relatively frequent penile-vaginal sex, unprotected by a condom, among inner-city African American adolescents during their first or second trimester of pregnancy. Study Design: Baseline data collected as part of an HIV prevention study were used. Adolescents at their first prenatal visit completed a self-administered survey and face-to-face interview. Only adolescents reporting a current boyfriend were included in this exploratory analysis (n = 144). Significant bivariate correlates were assessed for multivariate significance. Results: Significant bivariate correlates of relatively frequent unprotected vaginal sex were older age (P < 0.02), primiparity (P < 0.03), not being enrolled in school (P < 0.02), not residing with at least one parent (P < 0.001), reported infrequent sexual communication (communicating about sex) with the boyfriend (P < 0.01), spending at least 30 hours each week with the boyfriend (P < 0.001), reporting that the age of the current relationship was at least 2 years (P < 0.04), and using marijuana in the past 30 days (P < 0.03). Three correlates retained significance in the multivariate model not residing with at least one parent (adjusted odds ratio [AOR] = 2.24; P < 0.04), spending at least 30 hours with the boyfriend each week (AOR = 3.70; P < 0.002), and infrequent sexual communication with the boyfriend (AOR = 2.88; P < 0.008). Conclusion: Given the potential of STDs to complicate pregnancy outcomes, clinic-based and community-based programs addressing relational dynamics and relational obstacles to safer sex may be warranted, particularly for adolescents not residing with parents.