Exploring the mediating mechanism between gender-based violence and biologically-confirmed STD among detained youth

Background: To determine the relation between gender-based violence (GBV) and sexually transmitted disease (STD) outcomes among a sample of sexually active detained adolescent females and to identify the sexual risk behaviors that mediate the relationship. Methods: A cross-sectional survey of 212 adolescent females (14-18 years of age) recruited within 8 detention facilities. GBV victimization, sexual risk behaviors engaged in during the 2 months prior to their detention and, among those who used male condoms, the number of times a condom had broken, leaked, or fallen off in the previous 2 months. Measures were collected using audio-computer assisted self-interviewing. DNA amplification for the presence of C. trachomatis and N. gonorrhoeae was conducted. Results: 31% had experienced either physical abuse or sexual abuse from their boyfriend while 11% had experienced both; 16% tested positive for at least one STD. Controlling for race, compared to girls who had not been victimized, girls who were victims of GBV were 2.3 times as likely (95% CI = 1.002-5.53) to test positive for an STD. Moreover, condom error emerged as a significant mediator of this relationship whereas the other sexual risk behaviors did not. Conclusions: Detained adolescent girls are an extremely vulnerable population reporting high rates of GBV, which through its association with condom error places them at heightened risk for STDs. STD-HIV prevention programs for this population must address multiple relational issues.