High Prevalence and Incidence of Sexually Transmitted Diseases in Urban Adolescent Females Despite Moderate Risk Behaviors

Bunnell, Rebecca; Dahlberg, Linda L.; Rolfs, Robert T.; Ransom, Raymond; Farshy, Carol E.; Newhall, Wilbert J.; Schmid, Scott; Stone, Katherine M.; Louis, Michael St.

doi:10.1086/315080

Cited by 115 publications

(56 citation statements)

References 36 publications

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“…The partner's sexual behaviour has an impact on the presence of STIs in women [23][24][25]. In general, in Brazil, male promiscuity is considered normal and socially acceptable, and is often accepted by the female partners [26].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for sexually transmitted infections in women in rural Northeast Brazil

Oliveira

Lang

Ehrig

et al. 2008

J Infect Dev Ctries

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Background: Sexually transmitted infections (STIs) are highly prevalent in northeast Brazil, but factors associated with the presence of an STI have rarely been studied systematically. Methodology: We performed a population-based study to assess factors associated with STIs in women of reproductive age (12 to 49 years) in a rural setting in northeast Brazil. A total of 734 women were eligible; 592 (80.7%) had initiated sexual life and were included. Women were examined for the presence of an STI. Socio-economic variables, sexual history, and behaviour were assessed through a structured questionnaire. Laboratory testing included: polymerase chain reaction for human papillomavirus (HPV); ligase chain reaction for Chlamydia trachomatis and Neisseria gonorrhoeae; VDRL and FTA-ABS for Treponema pallidum; analysis of wet mounts, gram stain and Pap smears for Trichomonas vaginalis; and ELISA for HIV. Results: At least one STI was present in 112 (19.6%) of the women. In logistic regression analysis, a previous visit to a Pap smear clinic was protective against an STI (OR=0.26; IC 95%: 0.12-0.57). The following variables were independently associated with STIs: ≥3 partners in life (2.35; 1.32-4.17); first pregnancy <16 years of age (2.28; 1.09-4.78); not knowing if partner had another partner (3.56; 1.09-11.62). Conclusions: The protective and risk factors identified can guide the implementation of gender-and age-specific control programs in rural northeast Brazil. Offering a simple preventive measure (Pap smear collection), usually done by a nurse in this setting, may be a useful opportunity for diagnosis and treatment of curable STIs, without considerable additional costs.

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Section: Discussionmentioning

confidence: 99%

Risk factors for sexually transmitted infections in women in rural Northeast Brazil

Oliveira

Lang

Ehrig

et al. 2008

J Infect Dev Ctries

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“…The regional variation in these rates for each racial group is different than that noted for the combined rates of the two racial groups (Farley, 2006). From a structural perspective, higher STD rates are affected by the social, medical, and economic environment (Adimora et al, 2001;Aral & Holmes, 1999;Bunnell et al, 1999;Cohen et al, 2000;Elliott et al, 2002;Gunn, Fitzgerald, & Aral, 2000;St.Louis, Farley, & Aral, 1996). Given these three perspectives, it seems important when analyzing the association between social capital and STD rates at the state level to control for compositional, clustering, and structural determinants that affect exposure to and infection with STDs and that affect state variation in STD rates.…”

Section: Introductionmentioning

confidence: 97%

Social capital and rates of gonorrhea and syphilis in the United States: Spatial regression analyses of state-level associations

Semaan

Sternberg

Zaidi

et al. 2007

Social Science & Medicine

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We conducted spatial regression analysis to account for spatial clustering of sexually transmitted diseases (STDs) and to examine the state-level association between social capital (using Putnam's public use data set) and rates of gonorrhea and syphilis. We conducted the analysis for the 48 contiguous states of the United States for 1990, 1995, and 2000 and controlled for the effects of regional variation in STD rates, and for state variation in poverty, income inequality, racial composition, and percentage aged 15-34 years. We compared the results of the spatial regression analysis with those of ordinary least squares (OLS) regression. Controlling for all population-level variables, the percentage of variation explained by the OLS regression and by the spatial regression were similar (mid-90s for gonorrhea and low-70s for syphilis), the standardized parameter estimates were similar, and the spatial lag parameter was not statistically significant. Social capital was not associated with STD rates when state variation in racial composition was included in the regression analysis. In this analysis, states with a higher proportion of residents who were African-American had higher STD rates. When we did not control for racial composition, regression analysis showed that states with higher social capital had lower STD rates. We conjecture that sexual networks and sexual mixing drive the association between social capital and STD rates and highlight important measurement and research questions that need elucidation to understand fully the relationship between social capital and STDs. r

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“…Among urban youth, teenage pregnancy is more normative due to its higher rates [28]. These negative outcomes are further compounded in metropolitan areas by elevated rates of poverty, incarceration, dense sexual networks, discrimination, racial segregation, and lack of health insurance and regular sources of care [1,9,22,50].…”

Section: Introductionmentioning

confidence: 99%

Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood

Green

Musci

Matson³

et al. 2017

J Urban Health

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Urban populations disproportionately experience poor sexual outcomes, including high rates of teenage pregnancy and sexually transmitted infections. However, the contribution of substance use across adolescence to poor sexual outcomes in young adulthood has not been investigated in depth, despite offering opportunities for more targeted prevention. This study aimed to estimate joint trajectories of adolescent alcohol and marijuana use to determine if they relate differently to four sexual outcomes: multiple sexual partners, sex without a condom, teenage pregnancy, and contraction of a sexually transmitted infection in young adulthood (by age 25). Data came from a longitudinal study of urban youth followed from age 6 to age 25, with annual assessments during adolescence and young adulthood (n = 608). The sample showed high levels of sexual risk, with young adults on average having sex without a condom once in the past month, 28.5% having multiple sexual partners in the past month, one quarter having contracted a sexually transmitted infection, and over 60% of the women being pregnant as a teenager and 36% of the men having gotten a partner pregnant. Applying longitudinal latent profile analysis to estimate joint trajectories of alcohol and marijuana use from grades 8-12, we identified four classes representing high dual use, moderate alcohol use, moderate alcohol use with increasing marijuana use, and nonuse. Class membership differently predicted all four outcomes investigated with high dual users having the highest level of teenage pregnancy and the increasing marijuana trajectory having the highest risk of engaging with multiple sexual partners in the past month. Results suggest implications for both sexual risk and substance use prevention for urban youth.

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High Prevalence and Incidence of Sexually Transmitted Diseases in Urban Adolescent Females Despite Moderate Risk Behaviors

Cited by 115 publications

References 36 publications

Risk factors for sexually transmitted infections in women in rural Northeast Brazil

Risk factors for sexually transmitted infections in women in rural Northeast Brazil

Social capital and rates of gonorrhea and syphilis in the United States: Spatial regression analyses of state-level associations

Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood

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