Background Examination of stress and post-traumatic stress disorder (PTSD) in relation to sexual and reproductive health (SRH) is limited. Stress, potentially by impairing immune response and increasing risk-taking behavior, may influence risk of poor SRH. ‘Weathering’ effects from chronic stress exposure that accumulate over time may further heighten risk.

Methods Using Wave IV data on 7870 women (ages 24–34) in the National Longitudinal Study of Adolescent to Adult Health, we defined high stress as scores ≥6 (75^th percentile) on the 4-item Perceived Stress Scale and PTSD as self-reported diagnosis by a healthcare provider; we categorized years since diagnosis as never, ≤2, 3–5, ≥6. Women reported lifetime and past year sexually transmitted infection (STI) and pelvic inflammatory disease (PID) diagnoses, adverse pregnancy outcomes (miscarriage, ectopic/tubal pregnancy, stillbirth), and impaired fecundity (difficultly becoming/staying pregnant). We used modified Poisson regression to estimate sociodemographic-adjusted prevalence ratios (APR) and 95% confidence intervals (CI).

Results Approximately 43% reported high stress and 4% PTSD (1% ≤2 years since diagnosis, 1% 3–5 years, 2% ≥6 years). High stress was associated with past year bacterial STIs (APR=1.53, 95%CI: 1.13, 2.09), unassociated with viral STIs, and weakly associated with adverse pregnancy outcomes (APR=1.24, 95%CI: 1.02, 1.50) and impaired fecundity (APR=1.13, 95%CI: 0.98, 1.30). PTSD was also associated with lifetime viral STIs (APR=1.40, 95% CI: 1.06, 1.83) and PID (APR=3.12, 95%CI: 1.59, 6.12). Compared to women never diagnosed with PTSD, APRs for past year bacterial STIs were 2.66 (95%CI: 1.28, 5.55) and 3.12 (95%CI: 1.49, 6.55) for women diagnosed ≤2 years and ≥6 years ago respectively, but not associated for women diagnosed 3–5 years ago.

Conclusion High ‘global’ perceived stress is associated with increased prevalence of poor SRH among women. Stronger associations were demonstrated in women with PTSD, particularly those with shorter and longer time since diagnosis, potentially suggesting both adverse acute and chronic stress responses.

Disclosure No significant relationships.