Relationship of abuse and pelvic inflammatory disease risk behavior in minority adolescents.
OBJECTIVE
Little is known about the relationship between minority adolescent's experiences of sexual or physical abuse and the pathology of gynecological symptoms that might have an impact on the diagnosis of sexually transmitted disease (STD) or risk for pelvic inflammatory disease (PID). The objective of this study was to determine the relationship of sexual or physical abuse to the pathology of genitourinary symptoms that impact diagnoses of STD and risk for PID among Mexican American and African American adolescent women with a current STD.


METHODS
Mexican American and African American adolescent women (n = 373) with an STD underwent a targeted physical exam and questioning regarding sexual or physical abuse, current genitourinary symptomatology, and risk behaviors known to be associated with PID to determine the relationship of sexual or physical abuse to the pathology of genitourinary symptoms that impact diagnoses of STD and risk for PID.


RESULTS
Bivariate comparisons found that abused adolescents (n = 232) reported more behaviors associated with increased risk for PID, including earlier coitus, more sex partners, higher STD recurrence, and delayed health-seeking behavior. Multivariate comparisons found that abused adolescents were more likely to report pathologic genitourinary symptomatology than those who were not abused. Clinicians reported more abnormal physical exams but did not make any more presumptive diagnoses of PID for abused than nonabused adolescents.


CONCLUSIONS
Delayed treatment for PID dramatically worsens future fertility and chronic pelvic pain. These findings demonstrate that abused adolescent women are at high risk for PID. Because of its considerable impact on risk for PID, an assessment for abuse is essential in clinical management of adolescent women with STD and diagnosis of PID.
Champion
Jane Dimmitt
JD
University of Texas Health Science Center, San Antonio, USA. dimmitt@uthscsa.edu
Piper
Jeanna M
JM
Holden
Alan E C
AE
Shain
Rochelle N
RN
Perdue
Sondra
S
Korte
Jeffrey E
JE
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D001741:Black or African American / Q000193:education / Q000208:ethnology* / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000208:ethnology*; D005163:Factor Analysis, Statistical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D017058:Mexican Americans / Q000193:education / Q000208:ethnology* / Q000706:statistics & numerical data; D008913:Minority Groups / Q000193:education / Q000523:psychology; D015999:Multivariate Analysis; D000292:Pelvic Inflammatory Disease / Q000208:ethnology*; D015995:Prevalence; D000297:Psychology, Adolescent; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology