Depression and HIV risk-related sexual behaviors among African American adolescent females

African American adolescent females aged 13 to 19 are among the fastest growing populations of new HIV infections, and those with mental illnesses are also at risk. Within this demographic, depressive symptoms have correlated with HIV risk-related sexual behaviors (HRRSB) including inconsistent condom use, multiple sexual partners, and early sexual debut. Little is known however, about underlying constructs resulting in HRRSB among clinically depressed African American adolescent females who seek mental health services, or about the links between depression and specific behavioral risks within this group. Guided by the Theory of Planned Behavior, the purpose of this sequential exploratory mixed methods research (QUAL&rarrQUAN) was to develop a better understanding of the context of sexual risk for HIV among clinically depressed African American adolescent females. African American adolescent females (N = 128, 13-19 years old) were recruited from outpatient mental health facilities and complimentary settings in the Hampton, Virginia and Philadelphia, Pennsylvania metropolitan areas to participate in individual interviews and/or anonymous surveys. The results indicate that the psychopathology of depression (i.e. low self-esteem, hopelessness, guilt, etc.) may create situations where clinically depressed African American adolescent females could become exposed to HIV. Participants recounted stories of how through fear of abandonment and the search for attention and emotional release, the inclination to acquiesce to one's partners demands (i.e. noncondom use, engaging in undesired sexual activity, etc.) is increased. Empirically, depression severity is a significant determinant of HRRSB including early sexual debut, inconsistent condom use, not inquiring about partners HIV status and engaging in sexual activity under the influence of drugs and/or alcohol. The condition is also a moderator of the relationship between adolescents' beliefs and intentions, and condom use at last sex. The results of this study have the potential to directly guide the modification and/or development of HIV prevention programs by providing explicit, psychologically and culturally relevant information regarding the interaction between depression and sexual risk for HIV among clinically depressed African American adolescent females.