A Longitudinal Examination of the Relationship Between Sexual Sensation Seeking and STI-Related Risk Factors Among African American Females

Purpose: Sexual sensation seeking has been correlated with STI-related risk factors in numerous cross sectional studies (Kalichman et al, 1996). However, no current studies have examined whether sexual sensation seeking is longitudinally related to a spectrum of STI-related factors such as consistent condom use, number of sexual partners, frequency of partner sexual communication, self-efficacy to refuse sex, and fear of condom negotiation. Hence, the purpose of this study is to understand the longitudinal effect of sexual sensation seeking on STI-related risk factors among African American adolescent girls.

Methods: Participants were African American females ages 15 to 21 (n=715) that were recruited from clinics that provide sexual health services to predominantly inner-city adolescents in downtown Atlanta, Georgia (DiClemente et al, 2009). All respondents had reported sexual activity in the previous 60 days. All measures were assessed using A-CASI technology. Sexual sensation seeking was assessed by a 9-item scale previously validated for African American youth (e.g. “When it comes to sex I am willing to try anything”). The study also assessed partner sexual communication frequency, self-efficacy to refuse sex, fear of condom negotiation, number of lifetime sexual partners, and proportion of condom use over 14 and 60 days. Generalized estimating equation (GEE) regression models were used to evaluate the influence of sexual adventurism on STI-related risk factors. The strength of GEE models lies in its ability to control for repeated within-subject measurements (6-month and 12-month follow up) over the longitudinal course of the study. Age and risky peer norms have been empirically and theoretically identified as significant confounders of sexual sensation seeking and STI risks and were controlled in all analyses. 

Results: Over the entire 12-month period, higher sexual sensation seeking predicted diminished partner sexual communication frequency (ß = -0.14; p ≤ .001), reduced self-efficacy to refuse sex (ß = -0.11; p ≤ .001), increased fear of condom negotiation (ß = 0.14; p ≤ .001) and more lifetime sexual partners ß = 0.94; p ≤ .001). Additionally, higher sexual sensation seeking predicted a lower proportion of condom use over 14 days (ß=-0.01; p ≤ .01) and 60 days (ß=-0.01; p ≤ .001). Furthermore, a one unit increase in sexual sensation seeking was associated with 7% lower odds of consistent condom use in the last 14 days (Adjusted OR = 0.93; 95% CI:0.89-0.97) and 8% lower odds of consistent condom use in the last 60 days (Adjusted OR = 0.92; 95% CI: 0.88-0.96).

Implications: Findings from this study provide evidence that higher sexual sensation seeking is longitudinally predictive of a broad spectrum of STI-related risk factors. Our findings have important prevention/intervention implications. Interventions that aim to enhance protective STI behaviors should assess for sexual sensation seeking among young African American females. Furthermore, intervention approaches should focus on enhancing situational and behavioral-specific protective factors (Carey & Lewis, 1999). For example, assisting individuals to channel their need for adventure into more productive channels (e.g. meaningful employment) or targeting change at larger systems levels such as changing peer influences (e.g. perceived peer network norms).