Objective: To determine the associations between hypothesized correlates and frequency of engaging in unprotected vaginal sex (UVS) among African American female adolescents at high risk of STD. Design: Cross-sectional study of 522 adolescents enrolled in an STD/HIV prevention intervention efficacy trial. Setting and Participants: A volunteer sample of adolescents recruited from neighborhoods characterized by high rates of unemployment, substance abuse, violence and STDs; 28% tested positive for STDs assessed by DNA amplification or culture. Main Outcome Measures: Frequency of UVS was assessed by interview, using a 6-month recall period. Results: For adolescents reporting steady relationships (n=477), more time with boyfriends and longer relationships were important correlates of greater UVS frequency, followed by perception of more girlfriends using condoms, ever having an STD, stronger normative beliefs favoring male control, greater pregnancy worry, and greater perceived invulnerability to STD. For adolescents reporting casual relationships (n=95), perceiving partner barriers to condom use was an important correlate, followed by ever having an STD, believing that other contraception prevents STD, and agreement with a statement indicating the male decides if they will have sex. Conclusions: Adolescents learn from the experience of having an STD; clinicians can capitalize on this finding by using the diagnosis of STDs as "teachable moments." Adolescent females at-risk or being treated for an STD need to know that familiarity with a sex partner does not protect from infection. Other strategies include increasing awareness that peers use condoms, teaching females how to overcome partner barriers to condom use, and promoting equitable relationships.
Learning Objectives: 1. Audience members will be able to identify correlates of unprotected vaginal sex for African American females in steady and in casual relationships with male partners. 2. Audience members will be able to apply information about unprotected vaginal sex among female teens to prevention program design and research issues related to African American female adolescents and HIV prevention
Keywords: Sexual Risk Behavior, Adolescents
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.