title: High prevalence and incidence of sexually transmitted diseases in urban adolescent females despite moderate risk behaviors.
abstract: To better understand the prevalence, incidence, and risk factors for sexually transmitted diseases (STDs) among female adolescents, a prospective 6-month cohort study was conducted at four teen clinics in a southeastern city. At enrollment, 260 (40%) of 650 sexually active females ages 14-19 years had an STD: chlamydia, 27%; herpes simplex virus type 2 (HSV-2), 14%; gonorrhea, 6%; trichomoniasis, 3%; and hepatitis B, 2%. At follow-up, 112 (23%) of 501 participants had an incident infection: chlamydia, 18%; HSV-2, 4%; gonorrhea, 4%; and trichomoniasis, 3%. At either enrollment or follow-up, 53% had >/=1 STD; of those with 1 lifetime partner, 30% had an STD. Having a new partner (odds ratio [OR], 2.2; 95% confidence interval [CI], 1. 1-4.2) or friends who sell cocaine (OR, 1.6; CI, 1.0-2.6) was independently associated with incident infection. STD incidence and prevalence were extremely high in this population, even in teenagers with only 1 lifetime partner. Individual risk behaviors appeared less important for STD risk than population factors.
authors.affiliation: Division of STD Prevention, Centers for Disease Control, Atlanta, GA 30315, USA. rrb7@usaid.gov
authors.forename: R E
authors.initials: RE
authors.lastname: Bunnell
authors.forename: L
authors.initials: L
authors.lastname: Dahlberg
authors.forename: R
authors.initials: R
authors.lastname: Rolfs
authors.forename: R
authors.initials: R
authors.lastname: Ransom
authors.forename: K
authors.initials: K
authors.lastname: Gershman
authors.forename: C
authors.initials: C
authors.lastname: Farshy
authors.forename: W J
authors.initials: WJ
authors.lastname: Newhall
authors.forename: S
authors.initials: S
authors.lastname: Schmid
authors.forename: K
authors.initials: K
authors.lastname: Stone
authors.forename: M
authors.initials: M
authors.lastname: St Louis
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D019966:Substance-Related Disorders; D014505:Urban Population