National study of the role of recent illicit substance use on the relationship between depressive symptoms and sexual risk behavior among child welfare-involved adolescents.

OBJECTIVE The present study examined the association between early-adolescent depressive symptoms and lifetime sexual risk behavior and whether that association was moderated by recent illicit substance use among adolescents reported for maltreatment. METHOD Data came from Waves 1 (baseline) and 4 (36-month follow-up) of the National Survey of Child and Adolescent Well-Being, a national probability study of youths undergoing investigation for abuse or neglect (n = 861). Multivariate logistic regression was used to explore main effects and moderation models among baseline depressive symptoms, lifetime sexual risk behavior, and recent illicit substance use. RESULTS Baseline depressive symptoms and recent illicit drug use played little role in predicting ever having intercourse, age at first intercourse, or pregnancy. Recent use of illicit substances moderated the relationship between early-adolescent depressive symptoms and condom use behavior (odds ratio = 0.85, p < .001) such that individuals who were more depressed at baseline and who used illicit drugs within the last 30 days were less likely to have often/always used condoms. Conversely, individuals with higher levels of depressive symptoms at baseline who had not engaged in illicit substance use in the last 30 days were more likely to often use condoms during sexual activity. CONCLUSIONS Results suggest that among adolescents reported for maltreatment, use of illicit substances may moderate the relationship between elevated levels of depressive symptoms during early adolescence and condom use as children age thorough adolescence. Interventions for child welfare-engaged youths should focus on prevention and treatment of depression and substance use.