Stage of change behavioral assessment tool fails to predict the prevalence of chlamydia in an urban adolescent health clinic.
OBJECTIVE
Strategies to reduce STI among adolescents and young adults have failed to consistently demonstrate effectiveness. A universal approach may not be appropriate because individuals are at different stages with respect to self-management behaviors. Thus, the Stage of Change Transtheoretical Model has been advocated. This study was conducted to determine whether staging could be accomplished in an urban adolescent clinic and whether it provides a tool to predict STI risk.


METHODS
Participants were interviewed and staged according to a standardized instrument with respect to sexual risk behaviors and contraceptive use.


METHODS
Urban adolescent health clinic.


METHODS
103 females (ages 18-24).


METHODS
A physical examination and diagnostic tests for syphilis, HSV, HCV, chlamydia, gonorrhea and HPV were performed.


METHODS
Stages for behaviors to reduce STI risk and to utilize contraception and STI prevalence.


RESULTS
78% of the participants were in the three earliest stages of behavior (precontemplative, contemplative, and ready for action) with respect to condom use for STI prevention; conversely only 47% were in early stages with respect to birth control practices. Of the participants tested, 12/81 (15%) had chlamydial infection detected by molecular techniques, whereas no participants had gonorrhoeae. Among the subset tested for HPV DNA, 18/45 (40%) were positive. The diagnostic behavior stage for STI prevention did not correlate with the presence of chlamydia.


CONCLUSIONS
A staging instrument can be implemented into adolescent health clinic practice, but cannot be used as a risk assessment tool for the presence of chlamydia. Additionally females are more likely to protect themselves against pregnancy than against an STI.
Kasowitz
Andrea R
AR
Department of Pediatrics, Mount Sinai School of Medicine, New York City, NY 10029, USA.
McCusker
Mark
M
Coury-Doniger
Patricia
P
Neal
Wendy P
WP
Indyk
Debbie
D
Burk
Robert D
RD
Jenkins
Stephen G
SG
Rickert
Vaughn I
VI
Herold
Betsy C
BC
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009519:New York City / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D015995:Prevalence; D018570:Risk Assessment; D012309:Risk-Taking; D012648:Self Care; D012725:Sexual Behavior / Q000523:psychology; D014504:Urban Health
D003271:Contraceptive Agents, Female