Presentation Authors: Kirkpatrick B. Fergus*, Hillary L. Copp, Jason M. Nagata, San Francisco, CA
Introduction: Adolescents and young adults are at increased risk of sexually transmitted infections (STI&[prime]s). Although it is well known that mental health can influence sexual risk, more research is needed to understand how body image in adolescence affects sexual behaviors in young adulthood. The objective of this study was to identify the association between adolescent self-perceived body image and sexual risk in young adulthood.
Methods: We used prospective cohort data of adolescents ages 11-18 who were followed through ages 18-26 from the National Longitudinal Study of Adolescent to Adult Health. The baseline sample was nationally representative with respect to region, urbanicity, size, type and ethnicity of students from 80 U.S. high schools with paired middle schools. Exposures of interest included self-perceived weight, physical fitness (11-18 years), and attractiveness (18-26 years). Sexual risk outcomes (at 18-26 years) include number of sexual partners and STI&[prime]s. Multivariable linear and logistic regression was used to predict sexual risk outcomes according to body image perception, stratified by sex.
Results: 11,770 participants met inclusion criteria at baseline, including 5,463 boys and 6,307 girls. At ages 18-26 years, the median number of sexual partners was 4 (IQR:2-8) and 7.5% reported having ever had a sexually transmitted infection. Adolescent self-perception of being &[Prime]very overweight&[Prime] was associated with a greater number of sexual partners (B=1.18, p=0.021) in females but fewer sexual partners (B=-2.20, p=0.002) in males compared to self-perception of &[Prime]about the right weight.&[Prime] Self-perception of being &[Prime]not at all attractive&[Prime] was associated with fewer sexual partners in both males and females (Table 1), and lower odds of STIs. Self-perceived physical fitness was associated with a greater number of partners in males but fewer partners in females.
Conclusions: Although self-perceived attractiveness was associated with greater sexual risk in both males and females, weight and fitness body image affected males and females differently. Differences in body image largely had no effect on STI acquisition in both males and females. Future research should further investigate sex differences in sexual risk factors in adolescents and young adults.