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Does the Sex Risk Quiz Predict Mycoplasma genitalium Infection in Urban Adolescents and Young Adult Women?

Ronda, Jocelyn, MD*; Gaydos, Charlotte A., DrPH*†; Perin, Jamie, PhD*†; Tabacco, Lisa, MPH*; Coleman, Jenell S., MD, MPH*; Trent, Maria, MD, MPH*†

doi: 10.1097/OLQ.0000000000000874
Original Studies

Background Mycoplasma genitalium (MG) is a common sexually transmitted infection (STI), but there are limited strategies to identify individuals at risk of MG. Previously, a sex risk quiz was used to predict STIs including Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. The original quiz categorized individuals 25 years or younger as at risk of STIs, but the Centers for Disease Control and Prevention identifies females younger than 25 years as at risk of STIs. In this study, the quiz was changed to categorize females younger than 25 years as high risk. The objective was to determine if the age-modified risk quiz predicted MG infection.

Methods A cross-sectional analysis of a prospective longitudinal study was performed including female adolescents and young adults (AYAs) evaluated in multiple outpatient clinics. Participants completed an age-modified risk quiz about sexual practices. Scores ranged from 0 to 10 and were categorized as low risk (0–3), medium risk (4–7), and high risk (8–10) based on the STI prevalence for each score. Vaginal and/or endocervical and/or urine specimens were tested for MG, T. vaginalis, C. trachomatis, and N. gonorrhoeae using the Aptima Gen-Probe nucleic amplification test.

Results There were 693 participants. Most participants reported having 0 to 1 sexual partners in the last 90 days (91%) and inconsistent condom use (84%). Multivariable logistic regression analysis controlling for race, education, and symptom status demonstrated that a medium-risk score predicted MG infection among AYAs younger than 25 years (adjusted odds ratio, 2.56 [95% confidence interval, 1.06–6.18]).

Conclusion A risk quiz may be useful during clinical encounters to identify AYA at risk of MG.

An age-modified sex risk quiz predicts infection with Mycoplasma genitalium among female adolescents and young adults younger than 25 years.

From the *Johns Hopkins School of Medicine;

Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Acknowledgments: This protocol was funded through a nonrestricted institutional grant from Hologic, Inc, with infrastructure support from the following grants: National Institute of Nursing Research NIH/NINR 5R01NR013507, U54EB007958, NIBIB, NIH; U-01068613, NIH, NIAID. The authors are grateful to Dr Pamela Matson, PhD, MPH, who provided secondary support and review of the statistical analysis before publication. The authors thank Mr Justin Hardick, MS, and Barbara Silver MT (ASCP), MBA, for performing microbiology testing for this study.

Conflict of Interest and Sources of Funding: Dr Ronda reports funding from the Johns Hopkins Institutional Training for Pediatricians (Grant T32H D044355) and the Adolescent Health Training Program (T32 HD052459) during the conduct of the study. Dr Trent reports unrestricted research grants from Hologic, Inc, and the National Institutes of Health, during the conduct of the study, and Dr Trent receives personal fees and other support from Church & Dwight, Inc, outside the submitted work. Dr Gaydos reports grants from Hologic, Inc, and the National Institutes of Health during the conduct of the study. Dr Coleman reports grants from the National Institutes of Health during the conduct of the study.

Correspondence: Jocelyn Ronda, MD, Department of Pediatrics, Johns Hopkins Medicine, 200 N. Wolfe St, No. 2083, Baltimore, MD 21287. E-mail: jronda1@jhmi.edu.

Received for publication January 30, 2018, and accepted May 16, 2018.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (http://www.stdjournal.com).

© Copyright 2018 American Sexually Transmitted Diseases Association