title: Associations between sexually transmitted disease diagnosis and subsequent sexual risk and sexually transmitted disease incidence among adolescents.
abstract: BACKGROUND
  Empiric evidence is lacking in regard to the subsequent sexually transmitted disease (STD)-associated risk behaviors of adolescents diagnosed and treated for an STD.
  
  
  OBJECTIVE
  The goal of this study was to prospectively identify associations between STD diagnosis and subsequent sexual risk and STD incidence among a sample of U.S. adolescents.
  
  
  METHODS
  A cohort of 455 adolescents (age 15-21 years) was followed for 3 months. Adolescents were recruited from primary care clinics and through outreach activities.
  
  
  RESULTS
  A total of 10.8% were initially diagnosed with at least one STD. After adjusting for observed covariates, these adolescents (compared with those testing negative) were 2.8 times (P = 0.0001) more likely to be abstinent from sex and 2.2 times more likely to report always using condoms (P = 0.04). However, during the ensuing 3 months, they were approximately 2.4 times more likely to report having sex with multiple partners (P = 0.01), 8.9 times more likely to test positive for trichomonas (P = 0.009), and 3.0 times more likely to test positive for chlamydia (P = 0.04).
  
  
  CONCLUSIONS
  Compared with those testing negative, adolescents diagnosed with an STD may subsequently adopt safer sex behaviors, including abstinence. However, perhaps in part as a result of having sex with multiple partners, they might fail to practice safer sex behaviors stringently enough to avoid subsequent STD acquisition.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, Georgia 30322, USA. rcrosby@sph.emory.edu
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: Laura F
authors.initials: LF
authors.lastname: Salazar
authors.forename: Eve
authors.initials: E
authors.lastname: Rose
authors.forename: David
authors.initials: D
authors.lastname: Levine
authors.forename: Larry
authors.initials: L
authors.lastname: Brown
authors.forename: Celia
authors.initials: C
authors.lastname: Lescano
authors.forename: David
authors.initials: D
authors.lastname: Pugatch
authors.forename: Timothy
authors.initials: T
authors.lastname: Flanigan
authors.forename: Isa
authors.initials: I
authors.lastname: Fernandez
authors.forename: William
authors.initials: W
authors.lastname: Schlenger
authors.forename: Barabra J
authors.initials: BJ
authors.lastname: Silver
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012237:Rhode Island / Q000453:epidemiology; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires