title: The protective value of school enrolment against sexually transmitted disease: a study of high-risk African American adolescent females.
abstract: 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.
authors.affiliation: College of Public Health, Lexington, KY 40506-0003, USA. crosby@uky.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Laura F
authors.initials: LF
authors.lastname: Salazar
authors.forename: Eve
authors.initials: E
authors.lastname: Rose
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
mesh_terms: 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*