Subsequent sexually transmitted infection in urban adolescents and young adults

Objective: To compare the rates of subsequent infection with Chlamydia trac homatis, Neisseria gonorrhoeae, or Trichomonas vaginalis in a group of high -risk adolescents and young adults. Methods: At the time of treatment, 444 unmarried teenagers and young adults aged 13 to 25 years were enrolled from an urban sexually transmitted disea se clinic and 3 community-based primary care clinics. Subjects were infecte d with C trachomatis, N gonorrhoeae, or T vaginalis, were diagnosed as havi ng nongonococcal urethritis (in men), or were uninfected sexual contacts wi th one of these infections. Subjects returned at 1, 3, 5, and 7 months. Results: The rate of subsequent infection was substantial. Forty percent of men and 53% of women who were uninfected contacts at enrollment were estim ated to be infected within 7 months; 60% of men and 73% of women infected a t enrollment were estimated to be reinfected. Among women, subjects who wer e infected at enrollment had a shorter time to subsequent infection (median , 140 days) compared with uninfected contacts (median, 209 days) (P=.04). A mong men, findings were similar, but the difference in median time to subse quent infection was not significant (P=.08). Baseline characteristics that predicted shorter time to reinfection were female sex and infection at enro llment. When sexual behaviors in the 2 months preceding each subsequent dat a collection visit were included in the model, only being female and report ing at least one new interval sexual partner were significant predictors of subsequent sexually transmitted infections. Conclusions: These data support recent research that has found high rates o f subsequent infection among high-risk adolescents and young adults. Contac ts of a sexually transmitted infection appear to be at equally high risk fo r subsequent infection as those with a personal history of infection. Our d ata suggest that more frequent than annual screening for N gonorrhoeae, C t rachomatis, and T vaginalis would be appropriate in at-risk adolescent and young adult populations, including individuals who are uninfected sexual co ntacts to a sexually transmitted infection.