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Infrequent Parental Monitoring Predicts Sexually Transmitted Infections Among Low-Income African American Female Adolescents
Richard A. Crosby, PhD;
Ralph J. DiClemente, PhD;
Gina M. Wingood, ScD, MPH;
Delia L. Lang, MPH, PhD;
Kathy Harrington, MPH, MAEd
Arch Pediatr Adolesc Med. 2003;157:169-173.
Objective To prospectively determine (using an 18-month follow-up period) the association between African American female adolescents' perceptions of parental monitoring and their acquisition of biologically confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis.
Design A prospective cohort study of 217 African American female adolescents enrolled in the control arm of a randomized trial of a human immunodeficiency virus prevention intervention program.
Setting and Participants A volunteer sample of adolescents (aged 14-18 years) recruited from low-income neighborhoods characterized by high rates of unemployment, substance abuse, violence, and sexually transmitted diseases.
Main Outcome Measures Adolescents provided 2 self-collected vaginal swab specimens. One was tested for C trachomatis and N gonorrhoeae DNA with ligase chain reaction. The other was used to inoculate culture medium for T vaginalis. Identical assay procedures were repeated at the 6-month, 12-month, and 18-month follow-up intervals.
Results Adjusted odds ratios indicated that adolescents who perceived infrequent parental monitoring at baseline were 1.8 (95% confidence interval, 1.01-3.21) and 2.4 (95% confidence interval, 1.22-4.87) times more likely to acquire chlamydia or trichomoniasis, respectively, compared with their counterparts who perceived greater levels of monitoring. Similarly, adolescents who perceived infrequent parental monitoring were 2.1 (95% confidence interval, 1.16-3.74) times more likely to test positive for a sexually transmitted infection during the course of the 18-month follow-up period.
Conclusions Adolescents' perceptions of their parental-monitoring levels predicted subsequent acquisition of biologically confirmed chlamydia and trichomoniasis infections. These findings suggest that expanded efforts leading toward effective clinic- and community-based sexually transmitted infection intervention programs involving parents may be warranted.
From the Department of Behavioral Sciences and Health Education, Rollins School of Public Health (Drs Crosby, DiClemente, Wingood, and Lang), Department of Pediatrics, Division of Infectious Diseases, Epidemiology and Immunology, and Department of Medicine, Division of Infectious Diseases, School of Medicine (Dr DiClemente), Emory University, Atlanta, Ga; the Emory/Atlanta Center for AIDS Research (Drs Crosby, DiClemente, and Wingood); and the Department of Pediatrics, School of Medicine, University of Alabama at Birmingham (Ms Harrington).
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