High prevalence and incidence of sexually transmitted diseases in urban adolescent females despite moderate risk behaviors

To better understand the prevalence, incidence, and risk factors for sexual ly transmitted diseases (STDs) among female adolescents, a prospective 6-mo nth cohort study was conducted at four teen clinics in a southeastern city. At enrollment, 260 (40%) of 650 sexually active females ages 14-19 years h ad an STD: chlamydia, 27%; herpes simplex virus type 2 (HSV-2), 14%; gonorr hea, 6%; trichomoniasis, 3%; and hepatitis B, 2%. At follow-up, 112 (23%) o f 501 participants had an incident infection: chlamydia, 18%; HSV-2, 4%; go norrhea, 4%; and trichomoniasis, 3%. At either enrollment or follow-up, 53% had greater than or equal to 1 STD; of those with 1 lifetime partner, 30% had an STD, Having a new partner (odds ratio [OR], 2.2; 95% confidence inte rval [CI], 1.1-4.2) or friends who sell cocaine (OR, 1.6; CI, 1.0-2.6) was independently associated with incident infection. STD incidence and prevale nce were extremely high in this population, even in teenagers with only 1 l ifetime partner. Individual risk behaviors appeared less important for STD risk than population factors.