Sexual Behavior and Sexually Transmitted Infections in a Probability Sample of Adolescents in Baltimore, MD

1. Prevalence and Correlates of STI BACKGROUND • 9% of Baltimore teens have an undiagnosed STI (6% Ct, 4%Tv) • In multivariate analysis, following factors associated with increased odds of infection: nonwhite race, more than 1 sexual partner in the past year, forced sex, incarceration (of respondent or sexual partner), previous STI diagnosis. • Nonwhite teens 10 times more likely than whites to have STI. • Adolescents more vulnerable to STIs than other ages. • Surveillance data (CDC) and the population-based NHANES indicate that 15-19-year-old females have highest reported rates of chlamydia. • 47% of U.S. high school students report having had sex (Youth Behavior Risk Survey). MONITORING STIs SURVEY PROGRAM (MSSP) • Monitors prevalence of undiagnosed STIs (chlamydia, trichomoniasis, gonorrhea) in Baltimore MD. • Probability samples of 15-35 year-olds in households with landline phones. • Data sources: 1) telephone audio computer-assisted self interview (T-ACASI); 2) mailed-in urine specimens tested for STIs. • 2281 T-ACASI interviews completed Sept 2006-Aug 2008. Risk Factors • 54% of teens have had more than one lifetime sexual partner • Most (64%) had 0 or 1 partner in the past year. Nonwhite teens more likely than whites to have had >1 partner in the past year, 41% v. 13%. • 11% of teens report being “hit, shoved or physically hurt by a partner.” • Nearly 10% of teens have been incarcerated; 16% have had sexual partner who was incarcerated. Incarceration of partner—but not respondent—more common among nonwhite than white teens (19% v. 4%). OBJECTIVES • Report prevalences of sexual activity, risk behaviors and undiagnosed STIs (chlamydia and trichomoniasis) among Baltimore adolescents ages 15-19, from 2006-08 MSSP. • Identify correlates of sexual activity and STI. Sexual Behavior and Sexually Transmitted Infections in a Probability Sample of Adolescents in Baltimore, MD E. Eggleston1, S.M. Rogers1, C.F. Turner2, S.Tan1, A.M. Roman3, W.C. Miller4, M.M. Hobbs4, E. Erbelding5, L. Ganapathi1 1Research Triangle Institute, Washington DC/RTP, NC; 2City University of New York, (Queens College & the Graduate Center); 3University of Massachusetts-Boston, 4University of North Carolina at Chapel Hill, School of Medicine; 5Johns Hopkins University, School of Medicine METHODS • Estimates weighted to account for differing probabilities of selection and postratification adjustment to match 2007 American Community Survey marginals for Baltimore, MD. • Bivariate and multivariate logistic regression conducted to measure associations between outcomes (having sexual intercourse and having an STI) and demographic, behavioral and health characteristics. RESULTS CONCLUSIONS 615 teens aged 15-19, completed T-ACASI interview. 76% (n=467) provided urine specimen, 461 valid for testing. • Prevalence of sexual experience among MSSP teens (71%) is higher than Baltimore HS students in YBRS (67%) and U.S. HS students overall (47%) • STI rates among Baltimore teens are higher than among U.S. teens: chlamydia: 6% (MSSP) v. 3% (NHANES), trichomoniasis: 4% (MSSP) v. 2% (NHANES). • Further research needed to explore racial disparities in measured levels of STI and sexual activity. Prevalence and Correlates of Sexual Experience • 71% of teens have experienced sexual intercourse • Nonwhite race, older age (18-19) and low educational level were associated, in multivariate analysis, with odds of being sexually experienced. Contact: eeggleston@rti.org