Psychological factors such as depression, conduct disorder, and substance use have been shown to be associated with increased sexual HIV-risk behavior in youth. Stressful life events have also been associated with sexual risk behavior. Existing research is limited about the influence of stressful life events and mental health on the sexual risk behaviors of out-of-school youth. The proposed study will examine the influence of symptoms of psychiatric disorders and environmental stressors on sexual risk behavior in a sample of inner-city African-American youth between the ages of 16 and 23 years old.

This dissertation will: (1) examine the relationship between symptoms of psychiatric disorder and substance use and sexual risk behavior and (2) evaluate the relationship of stressful life events and specific categories of stressors with sexual risk behavior. The study population is a sub-sample (n=617) of a larger study on the effects of a mental health intervention on disorder symptomatology. Data are collected through self-administered computer interviews. Mental health indicators will be measured using the CES-D and Beck Anxiety Inventory. Stressful life events are assessed using a stressful life events checklist. Sexual risk behaviors assessed include condom use, lifetime sexual partners, and age of first sex. Study aims will be addressed using multivariate logistic regression.

Results indicate that mental health problems are positively associated with sexual risk behaviors and that these associations vary by gender. Stressful life events were only significantly associated with multiple sexual partners. However, stressors were more strongly associated with sexual risk behavior in males compared to females. The study's findings demonstrate that there are differing mechanisms by which environmental stressors and mental health problems influence sexual risk behavior.

Our findings highlight the need for additional research that examines the mechanisms by which mental health and stressors lead to sexual risk behavior, particularly the role of coping mechanisms. Additional longitudinal research is also needed that seeks to determine the temporal ordering of stressful life events, mental health problems, and sexual risk behavior. Our results substantiate the usefulness of multi-level HIV prevention programs that address mental health as an important component of sustained HIV risk reduction.