Study objective To describe the prevalence and correlates of vaginal douching among urban African American adolescents and to examine the association between douching and STI status. Design: Demographic, psychosocial, and behavioral data were collected through cross-sectional, self-administered surveys. Self-collected vaginal swabs were assayed using NAAT for trichomoniasis, Chlamydia, and gonorrhea. Setting Sexual health clinic in a large metropolitan area of the Southeast Participants African American females (N=701) ages 14 to 20 participating in an HIV prevention intervention Main outcome measure The outcome of interest was the association between vaginal douching (lifetime, past 90 days, and past 7 days) with demographic characteristics (e.g. age, education, and socioeconomic status), physical and mental health status, STI status, sexual behavior (e.g. number of vaginal sexual partners, age of sex partners, consistent condom use in the past 90 days, sex while self/partner was high on drugs or alcohol), and psychosocial characteristics (e.g. sexual adventurism, social support, peer norms, sexual happiness, self-efficacy for sex refusal, self-esteem, relationship power, risk avoidance). Results Forty-three percent reported ever douching, and 29% reported douching in the past 90 days. In bivariate analyses, recent douching was associated with demographic, behavioral, and psychosocial variables, but not current STI status. In multivariate analyses, recent douching was associated with age (AOR=1.13, CI=1.02–1.25), lower socio-economic status (AOR=1.25, CI=1.05–1.47), and having sex with much older partners (AOR=1.87, CI=1.22–2.86). Conclusion Increased age, lower socioeconomic status, and older partners may be salient risk factors for douching behavior among African American young women.