The Relationship Between Suicide and Sexual Behaviors Among Middle School Students

Introduction: There is little research available analyzing suicidal thoughts, plans or attempts and the association with sexual behaviors of middle school students.  As risky sexual behaviors increase, so do negative health outcomes including HIV/STDs and unplanned pregnancy. This study examined the relationship between middle school student sexual behaviors and three suicide-related outcomes: thoughts, plans, and attempts.

Methods: 2009 Youth Risk Behavior Middle School Survey data were obtained from three large school districts in the south.  The district data collections followed CDC protocol including randomization and obtaining at least the 60% response rate required to calculate weighted data.  Data were managed using SAS and analyzed using SUDAAN.  Frequencies and Chi Squares were tabulated.  Multivariate logistic regressions were run to see if suicidal thoughts, plans, or attempts are associated with sexual behaviors among students; gender, grade and race were used as covariates.

Results:  Among students who thought about suicide, significantly more students reported ever having sex compared to their counterparts (35% vs. 19%, p<0.0001). Among students who planned a suicide attempt, one-third reported ever having sex compared to one-in-five students who did not plan a suicide attempt (p<0.0001). Significantly more students who attempted suicide reported ever having sex compared to their counterparts (45% vs. 21%, p<0.0001). Those who responded "yes" to the three suicide questions were significantly more likely to have had sex before age 11 compared to their counterparts: thought about suicide, 10% vs. 5% (p=0.007); planned suicide, 12% vs. 5% (p=0.002); attempted suicide, 17% vs. 5% (p=0.0002). Those who attempted suicide were also more likely to have had 3 or more sex partners compared to their counterparts (14% vs. 8%, p=0.02). Conversely, those who responded "yes" to the three suicide questions were significantly less likely than their counterparts to report using a condom during their last sexual encounter: thought about suicide, 59% vs. 72% (p=0.0002); planned suicide, 55% vs. 72% (p=0.003); attempted suicide, 51% vs. 72% (p=0.0007).  Results from multivariate logistic regressions will also be presented. 

Conclusions: While the majority of middle school youth are not yet sexually active, a substantial group is.  Students who report ever thinking about suicide, planning suicide, or attempting suicide are more likely to engage in risky sexual behaviors. These behaviors result in an increased risk of HIV transmission, STD transmission, and unplanned pregnancy.  Implications for multiple behavior risk reduction programs will be discussed.