African American adolescent females with multiple STDs: Are they different than their counterparts with only one STD or just unlucky?

Objectives: To test the hypothesis that African American adolescent females newly diagnosed with at least 2 STDs will differ from those diagnosed with only one STD regarding sexual risk behaviors and psychosocial mediators of risk. Methods: A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included an audio-computer assisted self-interview and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. The Gen-Probe Aptima Combo 2 assay was used to detect 18 types of human Papillomavirus. Results: More than 40% tested positive for at least one STD. Seventy-one adolescents (23.3%) tested positive for 2 or more. Compared to the 233 adolescents testing positive for a single pathogen differences were not found relative to frequency of having sex while high or drunk (P=.30), having sex with older male partners (P=.87), frequency of unprotected vaginal sex in the past 60 days (P=.69), number of male sex partners in the past 60 days (P=.58), currently having a casual sex partner (P=.20), and (as a proxy measure of risk) whether a condom was used the last time penile-vaginal sex occurred (P=.50). Differences in sexual adventurism (P=.44), fear of condom negotiation (P=.20), and depression (P=.84) were not found. The groups did not differ by age (P=.25). Conclusion: The weight of evidence suggests that African American adolescent females with multiple STDs are not appreciably different from those with one. Those with multiple infections may be victims of bad luck.