Sex partner concurrency, geographic context, and adolescent sexually transmitted infections.
BACKGROUND
Geographic areas characterized by a high prevalence of sexually transmitted infections (STIs) are critical to the maintenance and persistence of STIs within populations. Sex partner concurrency has been shown to be associated with increased risk for individual-level STIs.


OBJECTIVE
The objectives of this study were to determine whether gonorrhea rate per census block group and sex partner concurrency independently and interactively are associated with a current bacterial STI among adolescents.


METHODS
Face-to-face interviews and urine testing for Chlamydia trachomatis and Neisseria gonorrhoeae were conducted among female, sexually active, 14- to 19-year-olds presenting for reproductive clinic care between August 2000 and June 2002.


RESULTS
Gonorrhea rate per census block group and sex partner concurrency were not independently but were interactively associated with a current bacterial STI. Among participants with a main sex partner who practiced concurrency, living in high-prevalence geographic areas was significantly associated with a current bacterial STI.


CONCLUSIONS
The results suggest that geographic context may moderate an adolescent sex partner's behaviors. The research adds to the basic understanding of sexually transmitted disease transmission and acquisition in a high-prevalence inner-city setting.
Jennings
Jacky
J
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21224, USA. jjenning@jhsph.edu
Glass
Barbara
B
Parham
Patrice
P
Adler
Nancy
N
Ellen
Jonathan M
JM
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003710:Demography; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014504:Urban Health