PSYCHOSOCIAL AND BEHAVIORAL-FACTORS ASSOCIATED WITH RISK OF SEXUALLY-TRANSMITTED DISEASES, INCLUDING HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION, AMONG URBAN HIGH-SCHOOL-STUDENTS

The main purpose of this study was to evaluate the role of multiple psychosocial and knowledge-related antecedent factors that may predict sexual and alcohol and drug use behaviors that are associated with the transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus infection. Five hundred forty-four ninth-grade urban high school students were surveyed regarding knowledge, attitudes, and behaviors related to STDs and acquired immunodeficiency syndrome (AIDS). Results of multiple regression analyses indicate that higher levels of SID and AIDS knowledge were associated with lower levels of STD and AIDS anxiety (R2-DELTA = 0.09; p < 0.001), fewer negative attitudes toward people with AIDS (R2-DELTA = 0.09; p < 0.001), stronger perceptions of self-efficacy (R2-DELTA = 0.03; p < 0.01), and stronger peer affiliation (R2-DELTA = 0.02; p < 0.05). Negative attitudes toward people with AIDS were inversely related to knowledge (R2-DELTA = 0.08; p < 0.001), social support (R2-DELTA = 0.02; p < 0.01), and perceived self-efficacy (R2-DELTA = 0.01; p <0.05). Predictors of alcohol and drug use included perceived peer norms (R2-DELTA = 0.08; p < 0.001) and strong peer affiliation (R2-DELTA = 0.05; p <0.001). The best predictor of sexual risk behavior was alcohol and drug use (R2-DELTA = 0.07; p < 0.001). Lower levels of knowledge (R2-DELTA = 0.14; p < 0.001) and perceived peer norms (R2-DELTA = 0.05; p <0.05) predicted nonuse of condoms. Our results indicate that several factors relate to adolescent risk for STDs: the connection between peer influence and adolescent risk behaviors, the link between alcohol and drug use and sexual risk behavior, and the role of knowledge in determining nonuse of condoms.