Abstract
Background: Cross-sectional associations exist between sexual risk taking and mental health problems. Few studies have examined the mental health consequences of sexual risk taking using a prospective design.
Aims: To examine associations between (1) early sex (before age 16 years) and anxiety, depression, conduct and substance dependence disorders at 18 years, (2) multiple sex partners between ages 18 to 20 and 21 to 25 years, and anxiety, depression and substance dependence disorders at 21 and 26 years respectively and (3) acquisition of a sexually transmitted infection between 21 and 26 years and anxiety, depression and substance dependence disorders at 26 years.
Methods: Associations were estimated by logistic regression analyses using data from the Dunedin Multidisplinary Health & Development Study, a prospective cohort from birth to adulthood. Adjustment was made for prior psychiatric disorder.
Results: No significant associations were found between sexual risk taking and anxiety or depression. Early sex was associated with later conduct and substance dependence. Sex with multiple partners was associated with later substance dependence, an association stronger in females than males. Acquisition of a sexually transmitted infection was also associated with later substance dependence.
Conclusion: The observed prospective association between sexual risk taking and later substance dependence was independent of prior psychiatric disorder. Psychosocial factors that might explain this relation include general risk taking tendencies, shared context and motivation to use substances to reduce cognitive dissonance around sexual risk taking.