Gender Differences in Sexual Risk Practices and Suicidal Tendencies Among U.S. High School Students: Examining the Mediating Role of Teen Dating Violence

Background and Purpose: Sexual risk behaviors, teen dating violence (TDV), depression, and suicide are social and public health concerns that negatively impact the U.S. high school students. Research is unclear whether these syndemic factors are interrelated. Also, there is a need to understand gender differences among these syndemic factors to inform the development of gender-specific prevention and intervention programs. Drawing on the extant literature and syndemic theory, we examined the nuanced mechanism through which sexual risk practices influences suicidal tendencies and whether this relationship differ by gender.

 

Methods: Data for this study was drawn from 2015 Youth Risk Behavior Surveillance System (YRBSS), a national survey on health-risk behaviors among high school students across the United States. Adolescents between 14-18 years were included in the analysis (N=15,455). About half (50.03%) of them were female. The outcome variable for this study was suicidal tendencies which was conceptualized as adolescents’ propensity to have suicidal ideation or to make suicide attempts. We used the linear combination method to create a suicidal tendencies index. The exogenous variable, multiple sex partners (MSP), was conceptualized as adolescents’ engagement in sex with more than four partners. Teen dating violence was the mediating variable and was conceptualized as sexual and physical violence experiences. Data analysis was conducted using path analysis (Mplus 7.4) to assess the direct paths through which sexual risk practices relates to suicidal tendencies and whether this link is mediated by teen dating violence. In this model, we also examined a possible link between depression symptomologies and suicidal tendencies.

Results: Findings show that regardless of the adolescent’s gender, multiple sex partners would directly lead to suicidal tendencies (full sample: β = .017, p < .001; boys-only (β = .058, p < .001) and girls-only samples (β = .027, p < .001). Second, sexual violence partially mediated the negative effect of multiple sex partners on suicidal tendencies for both males and females. Third, students’ experience with physical dating violence partially mediated the positive effect of multiple sex partners on suicidal tendencies only the full sample, but no gender differences. Finally, having depression symptomologies would directly lead to higher suicidal tendencies for both males and females.

Conclusions and Implications:  Findings from this study revealed that adolescent boys and girls engaging in sexual risk behaviors are at increased risk for suicide. The study also found that experiencing teen dating violence is a major concern in this population as it is likely to magnify the influence of sexual risk practices on suicide tendencies. Future research and practice with adolescents should take into consideration prevention and intervention strategies that particularly target adolescents exhibiting risk factors discussed in this study. Practitioners should also work with adolescents in enhancing their coping strategies and stress management skills to reduce depression and suicidal tendencies.