244396 Treatment-seeking and Sexual Behavior among African-American Adolescent Females with STD Symptoms

Monday, October 31, 2011: 12:50 PM

Andrea Swartzendruber, MPH , Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
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 DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Context: Delayed STD treatment increases the likelihood of adverse health complications and secondary transmission.

Objective: To investigate treatment-seeking among African-American adolescent females presenting to reproductive health clinics with STD symptoms and sexual behavior after noticing symptoms.

Methods: Sociodemographic, psychosocial, sexual behavior and STD history data were collected via ACASI from 715 African-American adolescent females, 15-21 years, presenting to reproductive health clinics. Data were obtained prior to randomization in an HIV prevention intervention. Treatment-seeking and sexual behaviors were assessed among participants reporting STD symptoms. Logistic models assessed the correlates of delayed presentation ( ≥5 vs. <5 days) after noticing symptoms.

Results: A total of 155 (22%) participants reported STD symptoms. The median time since first noticing symptoms was 5 days (range: 0-200 days). Attempting treatment without medical assistance (22%) or with douching (25%) was common. Over half (59%) reported sex without a condom after noticing symptoms. Correlates of delayed presentation included: higher condom self-efficacy (OR: 1.05, p=.04), greater peer norms for risky behavior (OR: 1.07, p=.04), greater commitment to a future relationship with their main partner (OR: 1.07, p=.02); discussing symptoms with a female friend vs. someone else (OR: 2.15, p=.05) and douching to treat symptoms (OR: 2.82, p=.01). In multi-variable analyses, douching (AOR: 3.40, p=.01) and peer norms (AOR: 1.09, p=.05), remained statistically significant.

Conclusions: A substantial proportion of African-American female adolescents have unprotected sex between noticing STD symptoms and presenting for diagnosis and treatment. STD prevention and treatment programs may benefit by highlighting the risks of douching.

Learning Areas:
Public health or related research

Learning Objectives:
Describe the time it takes African-American adolescent females to present for reproductive health services after first noticing STD symptoms Identify the prevalence of unprotected sex between first noticing STD symptoms and presentation to a reproductive health clinic among African-American adolescent females Identify correlates of delayed presentation among African-American adolescent females with STD symptoms seeking reproductive health services Discuss how correlates of delayed presentation can inform the design of STD prevention and treatment programs for African-American adolescent females

Keywords: Adolescents, STD

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: MPH: Emory University Rollins School of Public Health, 1999 PhD Candidate: Johns Hopkins Bloomberg School of Public Health, 2012 expected graduation Extensive experience in research and programs domestically and internationally
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.