The protective value of school enrolment against sexually transmitted disease: a study of high-risk African American adolescent females.
OBJECTIVE
To identify whether school enrolment is protective against laboratory-confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors.


METHODS
A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included an audio-computer-assisted self-interview lasting about 60 min and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae.


RESULTS
In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance.


CONCLUSIONS
This study provides initial evidence suggesting that keeping high-risk African-American adolescent females in school (including forms of school that occur after high-school graduation) may be important from a public health standpoint.
Crosby
Richard A
RA
College of Public Health, Lexington, KY 40506-0003, USA. crosby@uky.edu
DiClemente
Ralph J
RJ
Wingood
Gina M
GM
Salazar
Laura F
LF
Rose
Eve
E
Sales
Jessica M
JM
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012572:School Health Services / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control* / Q000523:psychology; D047568:Unsafe Sex / Q000517:prevention & control / Q000706:statistics & numerical data*