title: Predictors of repeat Chlamydia trachomatis and/or Neisseria gonorrhoeae infections among African-American adolescent women.
abstract: BACKGROUND
  Young African-American women have the highest rates of Chlamydia trachomatis and Neisseria gonorrhoeae in the USA. The objective was to identify baseline predictors of repeat chlamydia and/or gonorrhoea infections among African-American adolescent women.
  
  
  METHODS
  Sociodemographic, psychosocial and behavioural data were collected at baseline and every 6 months for 2 years from 701 African-American women (14-20 years) enrolled in an HIV prevention trial. Vaginal swabs were self-collected at each visit and assayed for chlamydia and gonorrhoea using DNA amplification. Among participants testing positive for chlamydia and/or gonorrhoea at baseline, logistic regression analyses assessed baseline predictors of repeat infection.
  
  
  RESULTS
  Of 618 (88%) participants with ≥1 follow-up assessment, 123 (20%) had a positive chlamydia and/or gonorrhoea test result at baseline; 49 (40%) had a repeat infection during the study period. Of those with a repeat infection, 30 (61%) were positive at one follow-up visit, 18 (37%) at two visits and 1 (2%) at three follow-up visits. Controlling for age and intervention condition, impulsivity (AOR: 1.71, p=0.018) was associated with an increased likelihood, and having a boyfriend (AOR: 0.21, p=0.006) was associated with a decreased likelihood of repeat infection.
  
  
  CONCLUSIONS
  Repeat chlamydia and/or gonorrhoea infections are common among African-American adolescent women. Among young African-American women who test positive for chlamydia and/or gonorrhoea, tailored interventions for more impulsive adolescents and those not in a relationship may reduce risk of repeat infections. Given the high numbers of repeat infections after receipt of an evidence-based intervention, enhanced screening and treatment services for young men may be warranted.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov (NCT00279799).
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. alswart@emory.edu
authors.forename: Andrea
authors.initials: A
authors.lastname: Swartzendruber
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.forename: Teaniese Latham
authors.initials: TL
authors.lastname: Davis
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Eve
authors.initials: E
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008219:Lymphogranuloma Venereum / Q000453:epidemiology*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D012008:Recurrence; D014481:United States / Q000453:epidemiology; D014621:Vagina / Q000382:microbiology; D055815:Young Adult