title: Implications of racial and gender differences in patterns of adolescent risk behavior for HIV and other sexually transmitted diseases.
abstract: BACKGROUND
  Sexual and substance use behaviors covary in adolescence. Prevalence of HIV and other sexually transmitted diseases (STDs) differs according to race and gender, yet few studies have systematically investigated risk behavior patterns by subgroup, particularly with nationally representative data.
  
  
  METHODS
  A priori considerations and K-means cluster analysis were used to group 13,998 non-Hispanic black and white participants in the National Longitudinal Study of Adolescent Health, Wave 1, according to self-reported substance use and sexual behavior. Multinomial logit analyses examined racial and gender differences by cluster.
  
  
  RESULTS
  Among 16 clusters, the two defined by the lowest risk behaviors (sexual abstinence and little or no substance use) comprised 47% of adolescents; fewer than 1% in these groups reported ever having received an STD diagnosis. The next largest cluster-characterized by sexual activity (on average, with one lifetime partner) and infrequent substance use-contained 15% of participants but nearly one-third of adolescent with STDs. Blacks were more likely than whites to be in this group. Black males also were more likely than white males to be in three small clusters characterized by high-risk sexual behaviors (i.e., having had sex with a male or with at least 14 partners, or for drugs or money). Black females generally were the least likely to be in high-risk behavior clusters but the most likely to report STDs.
  
  
  CONCLUSIONS
  Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed.
authors.affiliation: School of Public Health, University of North Carolina, Chapel Hill, USA. carolyn_halpern@unc.edu
authors.forename: Carolyn Tucker
authors.initials: CT
authors.lastname: Halpern
authors.forename: Denise
authors.initials: D
authors.lastname: Hallfors
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Bauer
authors.forename: Bonita
authors.initials: B
authors.lastname: Iritani
authors.forename: Martha W
authors.initials: MW
authors.lastname: Waller
authors.forename: Hyunsan
authors.initials: H
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D016000:Cluster Analysis; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012309:Risk-Taking; D017678:Sex Distribution; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data