title: Youth violence and connectedness in adolescence: what are the implications for later sexually transmitted infections?
abstract: OBJECTIVE
  To examine associations between (1) youth violence victimization and perpetration and later sexually transmitted infections (STI) and (2) parent-family and school connectedness and later STI, and to explore the moderating role of connectedness on the associations between youth violence victimization and perpetration and later STI.
  
  
  METHODS
  We used data from Waves I and IV of the National Longitudinal Study of Adolescent Health, which provided a baseline weighted sample of 14,800 respondents. We used logistic regression to examine associations between youth violence and connectedness with self-reported ever STI diagnosis, including gonorrhea, chlamydia, syphilis, genital herpes, genital warts or human papillomavirus, or human immunodeficiency virus. If participants reported having an STI at Wave I they were excluded from the analysis.
  
  
  RESULTS
  Controlling for biological sex, race/ethnicity, age, parent's highest education level, and parent's marital status, both youth violence victimization and perpetration were associated with an increased risk of later STI (adjusted odds ratio [AOR], 1.27, 95% confidence interval [CI], 1.07-1.52; and AOR, 1.21, 95% CI, 1.04-1.41, respectively). Parent-family and school connectedness in adolescence were associated with a decreased risk for later STI (AOR, .96, 95% CI, .95-.98; and AOR, .97, 95% CI, .95-.99, respectively); however, connectedness did not moderate the associations between nonsexual violence involvement and later STI.
  
  
  CONCLUSIONS
  These results indicate that youth violence victimization and perpetration may be risk factors for STI later in life. Conversely, parent-family and school connectedness in adolescence appear to protect against subsequent STI. The findings suggest that provider efforts to address youth violence and connectedness in adolescence can promote positive sexual health outcomes in adulthood.
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: rsteiner@cdc.gov.
authors.forename: Riley J
authors.initials: RJ
authors.lastname: Steiner
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Michael
authors.affiliation: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Hall
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Barrios
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Leah
authors.initials: L
authors.lastname: Robin
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D019548:Crime Victims / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D063588:National Longitudinal Study of Adolescent Health; D010287:Parent-Child Relations; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014754:Violence
keywords: Family connectedness; School connectedness; Sexually transmitted infections; Violence