242157 Predicting Discordance between Self-Reports of Sexual Abstinence and Incident Sexually Transmitted Infections with African American Female Adolescents: Results from a 4-City Study

Monday, October 31, 2011

Jennifer L. Brown, PhD , Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA
Jessica M. Sales, PhD , Rollins School of Public Health Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
Ralph J. DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Laura F. Salazar, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Rachel Nash, MPH , Rollins School of Public Health, Emory University, Atlanta, GA
Peter A. Vanable, PhD , Center for Health and Behavior, Syracuse University, Liverpool, NY
Michael P. Carey, PhD , Syracuse University, Center for Health and Behavior, Syracuse, NY
Larry K. Brown, MD , Department of Child and Adolescent Psychiatry/Bradley Hasbro Research Center, Brown University Medical School/Rhode Island Hospital, Providence, RI
Dan Romer, PhD , Adolescent Health Communication Institute, University of Pennsylvania, Annenberg Public Policy Center, Philadelphia, PA
Robert F. Valois, MS, PhD, MPH , Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC
Bonita Stanton, MD , Department of Pediatrics, Wayne State University, Detroit, MI
Objective: To identify predictors of the discordance between self-reports of sexual abstinence and incident sexually transmitted infections (STIs). Methods: African American adolescent females (N = 964) from four mid-sized U.S. cities were recruited for an HIV/STI prevention trial. Self-reported sexual behaviors, demographics, and hypothesized psychosocial antecedents of sexual risk behavior were collected at baseline, 6-, 12-, and 18-month follow-up assessments. Urine specimens were also collected and tested for three prevalent STIs (chlamydia, gonorrhea, and trichomonas) at each assessment. Results: 17.4% of adolescents with a laboratory-confirmed STI reported either lifetime abstinence or recent abstinence from vaginal sex (discordant self-report). Bivariate analyses indicated discordant self-reports were associated with: (a) younger age; (b) lower STI knowledge; (c) belief that fewer peers were having sex; and (d) belief that more peers would wait until marriage to have sex. In a logistic regression analysis, lower STI knowledge (AOR = .83, 95% CI = .72-.96), belief that fewer peers were engaging in sex (AOR = .78, 95% CI = .61-.96), and belief that more peers will wait until marriage to have sex (AOR = 1.4, 95% CI = 1.1-1.7) were associated with discordant reports (Overall model: χ2 = 26.62; p < .001). Conclusions: Discordance between self-reported abstinence and incident STIs was marked among African American female adolescents. Lack of STI transmission knowledge and sexual behavior peer norms may result in underreporting of sexual behaviors. Use of sexual activity biological markers combined with strategies to improve self-report will enhance the validity of sexual health data.

Learning Areas:
Public health or related research

Learning Objectives:
1. To examine the prevalence of self-reported sexual abstinence among African-American adolescent females with laboratory confirmed sexually transmitted infections. 2. To identify predictors of discordance between self-reports of sexual abstinence and incident sexually transmitted infections. 3. To provide strategies to improve self-report data in sexual health research and discuss the implications of utilizing self-report data to evaluate the efficacy of STI/HIV prevention interventions.

Keywords: HIV Interventions, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Brown received her Masters and Doctoral Degrees in Clinical Psychology at Syracuse University. Dr. Brown has extensive research experience in the design, implementation, and evaluation of HIV/STD risk reduction interventions. Her research also investigates factors that contribute to risky sexual behavior among adolescents and adults who are at risk for HIV infection. In addition, her research examines measurement issues related to the assessment of health behaviors. Dr. Brown's graduate and post-doctoral training in clinical health psychology focused on the provision of psychological services to individuals infected with HIV/AIDS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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