title: Prevalence, correlates, and efficacy of selective avoidance as a sexually transmitted disease prevention strategy among African American adolescent females.
abstract: OBJECTIVE
  To identify the prevalence and correlates of selective avoidance (SA) of sexual intercourse among African American adolescent females at risk for sexually transmitted disease (STD) acquisition and transmission.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Health clinics.
  
  
  METHODS
  African American females (N = 715) between the ages of 15 and 21 years.
  
  
  METHODS
  Self-reported sexual behaviors and laboratory-confirmed STDs.
  
  
  RESULTS
  Among the participants, 35.4% used SA as a strategy to prevent STD acquisition; 25.7% used SA to prevent STD transmission. Use of SA was not associated with current STD status. In multivariable analyses, adolescents who had sexual intercourse with 2 or more partners in the past 60 days, those who had high fear related to condom use negotiation, and those who discussed STD prevention with their sexual partners were 2.05 times more likely (95% confidence interval [CI], 1.31-3.20), 1.55 times more likely (95% CI, 1.09-2.19), and 2.00 times more likely (95% CI, 1.38-2.90), respectively, to use SA to prevent STD acquisition, and the same groups were 2.62 times more likely (95% CI, 1.62-4.24), 1.60 times more likely (95% CI, 1.10-2.32), and 2.13 times more likely (95% CI, 1.39-3.26), respectively, to use SA to prevent STD transmission.
  
  
  CONCLUSIONS
  This study provides initial evidence suggesting that SA as a risk-reduction strategy specifically used to prevent STD acquisition and/or transmission may be common among African American adolescent females. Based on a lack of differences in STD prevalence, we recommend that clinicians and prevention programs discourage the use of SA as an STD prevention strategy and encourage adolescent females to use condoms consistently and correctly with all male sexual partners.
authors.affiliation: Division of Infectious Diseases, Epidemiology, and Immunology, Department of Pediatrics, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Ste 554, Atlanta, GA 30322, USA. rdiclem@sph.emory.edu
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.forename: Laura F
authors.initials: LF
authors.lastname: Salazar
authors.forename: Eve
authors.initials: E
authors.lastname: Rose
authors.forename: Jessica McDermott
authors.initials: JM
authors.lastname: Sales
authors.forename: Angela M
authors.initials: AM
authors.lastname: Caliendo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000554:Ambulatory Care Facilities; D000818:Animals; D044383:Black People; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003142:Communication; D017280:Condoms; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D006801:Humans; D009042:Motivation; D015999:Multivariate Analysis; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012746:Sexual Abstinence; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D014247:Trichomonas Vaginitis / Q000453:epidemiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014505:Urban Population; D001741:Black or African American