Predictors of sexually transmitted diseases (STDs) and sexual risk behaviors among racial/ethnic minority females

Background: This study examined the longitudinal factors associated with Sexually Transmitted Diseases (STDs), and sexual risk behaviors among racial/ethnic minority females.

Methods: A nationally representative sample of females (n=6,894) who enrolled in wave 1 (1995, ages 12-18) and wave 3 (2001, ages 17-25) of the National Longitudinal Study of Adolescent Health (Add Health) were analyzed. Chi-square tests and multivariate logistic regression analyses were conducted with considerations to the complex survey design. The main outcome measure included a positive test result for chlamydia, gonorrhea, or trichomoniasis on wave 3 urine specimens, and sexual risk behaviors including early sexual debut and sex in exchange for money.

Results: The prevalence of STDs was highest among African American females (22.1%), followed by Hispanics (6.3%), APIs (6.0%), and Whites (3.7%). In logistic regression analyses, compared with Whites, African American females showed greater risks in terms of being diagnosed with STDs (OR 5.3), of having early sexual debut (OR=1.5), and of sex in exchange for money (OR=13.4). Beside racial disparities, females who perceived that their mothers approved of their sexual activities during adolescence were more likely to have STDs (OR=1.3), and early sexual debut (OR=1.9). Lower GPA during adolescence was a significant predictor for STDs and early sexual debut (OR 0.7, and 0.8, respectively).

Conclusion: Black females are at highest risk for STDs and sexual risk behaviors compared to White females. More research efforts need to gear toward understanding the racial/ethnic differences, the role of GPA, and parent-adolescent communication in sexual practice among females.