The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70644

Sherry D. Broadwell, PhD, Ralph J. DiClemente, PhD, Gina M. Wingood, ScD, MPH, Richard Crosby, PhD, MA, Delia L Lang, PhD, MPH, and Laura F. Salazar, PhD. Rollins School of Public Health, Dept of Behavioral Sciences and Health Education, Emory University, 1520 Clifton Road, NE, Atlanta, GA 30322, 404-727-0237, sbroadw@emory.edu

Objective: We evaluated whether having multiple sex partners would be a risk factor predicting STD incidence, even after adjusting for the influence of condom use and other theoretically and behaviorally important factors.

Methods: Data from an HIV intervention trial that enrolled 522 African-American females, 14 to 18 years of age, were utilized. Recruitment sites were located in low- income neighborhoods of Birmingham, Alabama, characterized by prevalent unemployment, substance abuse, violence, teen pregnancy and STDs. Baseline STD screening using DNA technology and prompt directly observable single-dose treatment for those identified with either chlamydia, trichomoniasis, or gonorrhea ensured a disease-free cohort. At 6-month and 12-month follow-up, adolescents completed interviews assessing their sexual behavior and provided specimens that were evaluated for STDs.

Results: Using Generalized Estimating Equations (GEE) to estimate logistic regression parameters, and controlling for empirically and theoretically important covariates, adolescents who reported having multiple sex partners in the 12-month follow-up period, relative to those who reported monogamous relationships, were twice as likely to have a biologically confirmed STD (P=.001; 95% CI 1.34-3.10). Adolescents reporting inconsistent condom use during vaginal sex, relative to those who reported consistent condom use, were 1.3 times more likely to test STD-positive (P=.05; 95% CI 1.00-1.95).

Conclusions: Our findings suggest that, among African-American adolescent females, having multiple sex partners may be an important risk behavior for acquiring STDs, even after adjusting for covariates, including condom use. The implications of this finding for the design of STD prevention programs will be discussed.

Learning Objectives:

At the conclusion of the session, the participant will become familiar with:
• Key predictors of STDs among African American female adolescents.
• The use of Generalized Estimating Equations to determine the longitudinal association between key sexual behaviors and incident STD.
• STD prevention strategies.

Keywords: African American, Sexual Risk Behavior

Presenting author's disclosure statement:
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.