WHAT'S KNOWN ON THIS SUBJECT:The extent to which young adults' laboratory-confirmed sexually transmitted disease results and self-reported sexual behaviors are consistent has not been assessed in a nationally representative sample.
WHAT THIS STUDY ADDS:The primary purpose of this study was to determine whether young adults' reports of recent sexual behavior (presence of penile/vaginal sex in the previous 12 months) correspond with the presence of laboratory-confirmed nonviral STDs assessed by nucleic acid amplification testing. abstract OBJECTIVE: Self-reported behavior has been the cornerstone of sexual health research and clinical practice, yet advances in sexually transmitted disease (STD) screening provide researchers with the opportunity to objectively quantify sexual risk behaviors. However, the extent to which young adults' laboratory-confirmed STD results and selfreported sexual behaviors are consistent has not been assessed in a nationally representative sample.
PATIENTS AND METHODS:Data are derived from participants who completed wave 3 in the National Longitudinal Study of Adolescent Health. Young adults (N ϭ 14 012) completed an audio computerassisted self-interviewing survey and provided a urine specimen to detect the presence of Chlamydia trachomatis and Neisseria gonorrhoeae, and a polymerase chain reaction assay to detect Trichomonas vaginalis.
RESULTS:More than 10% of young adults with a laboratory-confirmed positive STD result reported abstaining from sexual intercourse in the 12 months before assessment and STD testing. After controlling for several sociodemographic factors, self-reported sex (versus those who reported abstinence) in the previous 12 months was significantly associated with testing positive, but the odds of testing positive were only slightly more than twofold (adjusted odds ratio: 2.11 [95% confidence interval: 2.097-2.122]).
CONCLUSIONS:Findings indicate discrepancy between young adults' positive STD status and self-reported sexual behavior. No significant correlates of discrepant reporting were identified. From a clinical standpoint, the discrepancies between STD positivity and self-reported sexual behavior observed in this nationally representative sample suggest that routine STD screening may be beneficial and necessary to reduce STD morbidity among young adults. Sexually transmitted diseases (STDs), including HIV, are a significant source of morbidity for adolescents and young adults. 1,2 Abstinence, monogamy, and consistent condom use are the primary HIV/STD-protective behaviors that public health intervention efforts target for adolescents and young adults. 3 Historically, self-reported behavior has been the cornerstone of sexual health research from large observational studies, such as the Youth Risk Behavior Surveillance and the National Longitudinal Study of Adolescent Health, referred to as Add Health, 4,5 to evaluating the efficacy of sexual riskreduction interventions. 6-8 However, advances in the microbiologic technology in the detection of common sexually transm...