Sexually Transmitted Diseases

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Sexually Transmitted Diseases:

Associations Between Sexually Transmitted Disease Diagnosis and Subsequent Sexual Risk and Sexually Transmitted Disease Incidence Among Adolescents

Crosby, Richard A. PhD*†; DiClemente, Ralph J. PhD*†‡§; Wingood, Gina M. ScD, MPH*†; Salazar, Laura F. PhD*†; Rose, Eve MPH*; Levine, David MD, FAAP∥; Brown, Larry MD¶; Lescano, Celia PhD¶; Pugatch, David MD**; Flanigan, Timothy MD††; Fernandez, Isa PhD‡‡; Schlenger, William PhD§§; Silver, Barabra J. PhD∥∥

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Background: Empiric evidence is lacking in regard to the subsequent sexually transmitted disease (STD)-associated risk behaviors of adolescents diagnosed and treated for an STD.

Goal: The goal of this study was to prospectively identify associations between STD diagnosis and subsequent sexual risk and STD incidence among a sample of U.S. adolescents.

Study Design: A cohort of 455 adolescents (age 15–21 years) was followed for 3 months. Adolescents were recruited from primary care clinics and through outreach activities.

Results: A total of 10.8% were initially diagnosed with at least one STD. After adjusting for observed covariates, these adolescents (compared with those testing negative) were 2.8 times (P = 0.0001) more likely to be abstinent from sex and 2.2 times more likely to report always using condoms (P = 0.04). However, during the ensuing 3 months, they were approximately 2.4 times more likely to report having sex with multiple partners (P = 0.01), 8.9 times more likely to test positive for trichomonas (P = 0.009), and 3.0 times more likely to test positive for chlamydia (P = 0.04).

Conclusions: Compared with those testing negative, adolescents diagnosed with an STD may subsequently adopt safer sex behaviors, including abstinence. However, perhaps in part as a result of having sex with multiple partners, they might fail to practice safer sex behaviors stringently enough to avoid subsequent STD acquisition.

© Copyright 2004 American Sexually Transmitted Diseases Association


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