Associations Between Psychiatric Impairment and Sexual Risk Behavior Among Teens in Mental Health Treatment

The authors' aims were to assess the associations of sexual risk behavior with psychiatric impairment and individual, peer, and partner attitudes among adolescents receiving mental health treatment. Adolescents (N = 893, 56% female, 67% African American) completed assessments of psychiatric impairment, rejection sensitivity, peer norms, HIV knowledge, perceived vulnerability, self-efficacy, and condom use intentions. Two structural equation models were used to test the study hypotheses: one for sexually active youth and one for nonactive youth. For nonactive youth, psychiatric impairment influenced self-efficacy and condom use intentions via peer norms, rejection sensitivity, and perceived vulnerability. Among the sexually active youth, sexual risk was related to impairment and previous condom use. These results suggest that individual, peer, and partner factors are related to impairment and to sexual risk attitudes but depend on previous sexual experience.