Incidence and prevalence of chlamydia, herpes, and viral hepatitis in a homeless adolescent population.
BACKGROUND
High rates of unprotected intercourse and illegal drug use have been reported among homeless adolescents. As a transient population with the potential to act as disease vectors from one location to another, incidence and prevalence of sexually transmitted infections in this population are of particular concern.


OBJECTIVE
To assess a homeless adolescent population for incidence and prevalence of Chlamydia trachomatis, herpes simplex virus type 2, hepatitis B virus, hepatitis C virus, HIV, and psychosocial correlates of the acquisition of sexually transmitted infections.


METHODS
Longitudinal with assessments at baseline, 3 months, and 6 months (n = 536; 319 males and 217 females).


RESULTS
Baseline prevalence of C trachomatis was 4.17% for males and 6.30% for females. Prevalence of herpes simplex virus type 2 was 5.73% for males and 12.50% for females. Hepatitis B virus and hepatitis C virus prevalences were 3.60% and 5.0%, respectively. HIV seroprevalence was 0.3%. The incidence of sexually transmitted infections was significantly higher among females than among males (16.7% versus 9.8%) and was associated with inconsistent condom use and, for females, number of partners and sex with older partners. Incident hepatitis B virus and hepatitis C virus infection rates were 3.44% and 6.61%, respectively; both were associated with injection drug use.


CONCLUSIONS
Among females, the incidence of herpes simplex virus type 2 (> 25%) and C trachomatis (12%) was relatively high. Inconsistent condom use was the primary factor associated with a significantly greater risk of incident sexually transmitted infections. This was especially true for females with multiple partners. Homeless adolescents also are at high risk for hepatitis B virus and hepatitis C virus infection, primarily associated with self-reported injection drug use.
Noell
J
J
Oregon Research Institute, Eugene 97403, USA. johnn@ori.org
Rohde
P
P
Ochs
L
L
Yovanoff
P
P
Alter
M J
MJ
Schmid
S
S
Bullard
J
J
Black
C
C
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000367:Age Factors; D002690:Chlamydia Infections / Q000453:epidemiology*; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006525:Hepatitis, Viral, Human / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000453:epidemiology*; D018453:Homeless Youth; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D015205:Northwestern United States / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D019966:Substance-Related Disorders