Sexually transmitted diseases in a health maintenance organization teen clinic: associations of race, partner's age, and marijuana use.
OBJECTIVE
To determine the role of sociodemographic risk markers and behavioral risk factors associated with sexually transmitted diseases (STDs) in sexually experienced youth seeking care at an urban, general health maintenance organization teen clinic.


METHODS
Cross-sectional.


METHODS
A consecutive, racially and ethnically diverse sample of 285 sexually experienced youth who were preponderantly female (58.6%) and who were aged 16.7 years on average.


METHODS
All participants completed a self-report questionnaire and were screened for Chlamydia trachomatis using the ligase chain reaction technique and for Neisseria gonorrhoeae and other STDs using conventional methods.


RESULTS
Many of these youth were at high risk for STDs, having a self-reported history of sex with multiple partners (49.1%), sex with a new partner (42.5%), inconsistent use of condoms (71.9%), and frequent substance use (24.5% used marijuana 1-2 times per week or more). Sexually transmitted disease screening revealed that 11.6% of the participants had 1 or more STDs. A logistic regression analysis to determine the best model for predicting STDs indicated that youth who are African American (odds ratio, 3.34; 95% confidence interval, 1.52-7.35), had sexual partners who were 2 or more years older (odds ratio, 2.63, 95% confidence interval, 1.22-5.67), and used marijuana 1 to 2 times or more per week (odds ratio, 2.27; 95% confidence interval, 1.01-5.13) were more likely to have STDs at screening.


CONCLUSIONS
A brief sociodemographic and behavioral risk assessment that includes these factors may be useful for clinicians in deciding when to screen for STDs in sexually active youth seeking care for reasons not related to reproductive health.
Boyer
C B
CB
Department of Pediatrics, University of California, San Francisco 94143-0503, USA. boyer@itsa.ucsf.edu
Shafer
M A
MA
Teitle
E
E
Wibbelsman
C J
CJ
Seeberg
D
D
Schachter
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002690:Chlamydia Infections / Q000453:epidemiology; D002692:Chlamydia trachomatis; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D016017:Odds Ratio; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology