Relationships among depressive symptoms, sexually transmitted infections, and pregnancy in African-American adolescent girls

Abstract

Study objective: To explore relationships among depressive symptoms, sexually transmitted infections (STI), and pregnancy in African-American adolescent girls.

Design: Retrospective chart review.

Setting: A hospital-based outpatient practice serving primarily African-American patients.

Participants: A total of 126 female patients ages 13-19 years who had ligase chain reaction (LCR) for N. gonorrhoeae and C. trachomatis.

Methods: Charts were reviewed for history of STI, history of pregnancy, LCR results, and a history of depressive symptoms as indicated by standardized provider notes and patient self-administered questionnaire. Data are compared using Fisher's exact test.

Results: Mean age was 16.6 years (+/-1.6 years); 19.8% of participants had a history of depressive symptoms, 40.5% had a history of STI, 8.7% had a prior pregnancy, and 18.2% had a positive LCR. Of patients with a history of depressive symptoms, 64% had a history of STI compared to 34.6% of those without depressive symptoms (P = 0.01). A positive LCR was found in 20% of patients with a history of depressive symptoms and 17.8% of patients without (P = 0.78). Of patients with a history of depressive symptoms, 12% had a prior pregnancy compared to 7.9% without such history (P = 0.45).

Conclusions: African-American adolescent females in our clinic with a history of depressive symptoms were more likely to have a history of STI. A greater percentage of patients with a history of depressive symptoms also had prior pregnancies and/or current STI. Sexually active adolescent girls should be screened for depressive symptoms as part of their evaluation for sexual risk behaviors.