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Associations of Race, Partner's Age, and Marijuana Use

Cherrie B. Boyer, PhD; Mary-Ann Shafer, MD; Eileen Teitle, NP; Charles J. Wibbelsman, MD; Donald Seeberg; Julius Schachter, PhD

Arch Pediatr Adolesc Med. 1999;153:838-844.

Objective  To determine the role of sociodemographic risk markers and behavioral risk factors associated with sexually transmitted diseases (STDs) in sexually experienced youth seeking care at an urban, general health maintenance organization teen clinic.

Design  Cross-sectional.

Participants  A consecutive, racially and ethnically diverse sample of 285 sexually experienced youth who were preponderantly female (58.6%) and who were aged 16.7 years on average.

Methods  All participants completed a self-report questionnaire and were screened for Chlamydia trachomatis using the ligase chain reaction technique and for Neisseria gonorrhoeae and other STDs using conventional methods.

Results  Many of these youth were at high risk for STDs, having a self-reported history of sex with multiple partners (49.1%), sex with a new partner (42.5%), inconsistent use of condoms (71.9%), and frequent substance use (24.5% used marijuana 1-2 times per week or more). Sexually transmitted disease screening revealed that 11.6% of the participants had 1 or more STDs. A logistic regression analysis to determine the best model for predicting STDs indicated that youth who are African American (odds ratio, 3.34; 95% confidence interval, 1.52-7.35), had sexual partners who were 2 or more years older (odds ratio, 2.63, 95% confidence interval, 1.22-5.67), and used marijuana 1 to 2 times or more per week (odds ratio, 2.27; 95% confidence interval, 1.01-5.13) were more likely to have STDs at screening.

Conclusions  A brief sociodemographic and behavioral risk assessment that includes these factors may be useful for clinicians in deciding when to screen for STDs in sexually active youth seeking care for reasons not related to reproductive health.

From the Departments of Pediatrics (Drs Boyer and Shafer and Mr Seeberg) and Laboratory Medicine (Dr Schachter), University of California, San Francisco, and the Department of Pediatrics, San Francisco Kaiser Permanente Medical Center (Ms Teitle and Dr Wibbelsman).

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