title: Associations between biologically confirmed marijuana use and laboratory-confirmed sexually transmitted diseases among African American adolescent females.
abstract: BACKGROUND
  Numerous studies have examined the association between adolescents' marijuana use and their high-risk sexual behaviors and sexually transmitted diseases (STDs). However, the validity of the findings is questionable because most of the studies relied on self-reporting for measurement of marijuana use and key outcome (i.e., STDs).
  
  
  OBJECTIVE
  The goal was to investigate associations between biologically confirmed marijuana use and laboratory-confirmed STDs and condom use.
  
  
  METHODS
  African American females adolescents (n = 522) completed a self-administered survey and face-to-face interview. The adolescents provided urine and vaginal swab specimens that were analyzed for marijuana metabolites and STDs, respectively.
  
  
  RESULTS
  Among the study subjects, 5.4% tested positive for marijuana. These adolescents were more likely to test positive for Neisseria gonorrhoeae (adjusted odds ratio [AOR] = 3.4) and Chlamydia trachomatis (AOR = 3.9). They were more likely to have never used condoms in the previous 30 days (AOR = 2.9) and to have not used condoms consistently in the previous 6 months (AOR = 3.6).
  
  
  CONCLUSIONS
  The findings represent unique biologic evidence that STDs and sexual risk behavior may co-occur with marijuana use. Interventions designed to reduce adolescents' risk of STDs and HIV infection should address marijuana use.
authors.affiliation: Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Liau
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Diclemente
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.forename: Kim M
authors.initials: KM
authors.lastname: Williams
authors.forename: Kathy
authors.initials: K
authors.lastname: Harrington
authors.forename: Susan L
authors.initials: SL
authors.lastname: Davies
authors.forename: Edward W
authors.initials: EW
authors.lastname: Hook
authors.forename: M Kim
authors.initials: MK
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001741:Black or African American; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D019411:Clinical Laboratory Techniques; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008385:Marijuana Smoking / Q000652:urine*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012307:Risk Factors; D012725:Sexual Behavior; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology