title: Older partners and STD prevalence among pregnant African American teens.
abstract: BACKGROUND
  Several recent studies have addressed the question of whether adolescent females who have sex with older partners have a greater risk of sexually transmitted disease (STD) acquisition.
  
  
  OBJECTIVE
  The goal was to identify differences in STD prevalence and selected measures of behavioral risk between unmarried pregnant African American adolescent females reporting sex with older partners and those reporting sex with similar-age partners.
  
  
  METHODS
  Adolescents (n = 169) were recruited during their first prenatal visit. Adolescents completed a self-administered survey and a face-to-face interview and provided urine specimens for nucleic acid amplification assays.
  
  
  RESULTS
  Approximately 65% of adolescents reported that their male sex partners were >/=2 years older, while 35% reported having similar-age male sex partners. In age-adjusted analyses, adolescents with older partners were four times more likely to test positive for chlamydia (P < 0.04) and were more than twice as likely to report that their partner was also having sex with other women (P < 0.04). With use of a 30-day recall period, the mean number of unprotected vaginal sexual encounters among adolescents with older partners was 4.1, as compared to a mean of 6.9 among those reporting similar-age partners; this difference approached significance (P = 0.051). Prevalence of trichomoniasis as well as scale measures of adolescents' self-efficacy for condom negotiation and frequency of sexual communication with partners did not differ between those adolescents with older or similar-age male sex partners.
  
  
  CONCLUSIONS
  In resource-constrained clinical settings, one implication of these findings is that pregnant adolescents reporting older partners may be a priority for targeted delivery of partner services. More frequent screening for chlamydia may also be cost-effective for pregnant adolescents with older partners.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Elin
authors.initials: E
authors.lastname: Begley
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Eve
authors.initials: E
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D011253:Pregnancy in Adolescence; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*