Sexually Transmitted Diseases: Sexually Active Young Women Often Underestimate STD Risk
September 5, 2003
Most sexually active single women believe they are at low risk for contracting STDs, but a study, "Factors Associated with Condom Use Among At-Risk Women Students and Nonstudents Seen in Managed Care," published in Preventive Medicine (2003;37;(2):163-170), says otherwise. According to the research, the group's risk profiles are similar to women in higher-risk populations.
Researchers from Duke University Medical Center, the University of Washington-Seattle, and Group Health Cooperative of Puget Sound said their study highlights the need for health care clinicians to spend more time with young women identifying risk factors, explaining consequences of unprotected sex, and promoting condom use. STDs are a significant problem for young women, with national rates of HPV, genital herpes, and chlamydia particularly high among women ages 15 to 24. STDs can cause serious health complications, and recent research indicates HPV causes virtually all cervical cancer.
Researchers conducted phone surveys with 1,210 women to elicit information about demographic characteristics and risk behaviors such as episodes of binge drinking, history of vaginal sex and STDS, perceived STD risk, overall condom use, and partner-specific condom use. Women surveyed were sexually active, unmarried, not pregnant, and heterosexual, ages 18-25. Students and nonstudents participated in the analysis.
"Most research into condom use and STD risk focuses on populations considered 'high risk,' such as patients seen at STD clinics, inner-city clinics, and student clinics," said Kimberly Yarnall, M.D., lead author of the study. "In this study we wanted to include women not currently enrolled in college to find out what the average 'Jane' thinks. Nonstudents haven't really been surveyed to understand their views about condom use and STD risk."
Nonstudents tended to be older and nonwhite and reported more lifetime partners, having more partners over the previous 12 months than students, according to Yarnall. Both students and nonstudents reported the same rates of unprotected sex in the last 3 months, and more than 75 percent of all women surveyed perceived themselves at low risk for contracting an STD in the next year.
"In both groups, women were less likely to use condoms if they were older, white, on birth control pills or had partners that didn't see condoms as important," Yarnall said. "In the nonstudent women, binge drinking was significantly associated with unprotected sex among nonstudents, but that was not the case with the students." Yarnall said the connection may be explained by the fact that college students have educational programs about binge drinking and impaired judgment, while most nonstudents do not have access to such information.
Nonstudents were also more likely to have unprotected sex with someone they did not consider a committed partner, the study found. "Neither group had a great track record as far as safer sex," Yarnall noted. "But the college students did a little better overall. Students were less likely to have unprotected sex with someone they met at a party or a bar. Nonstudents were just as likely to have unprotected sex with their boyfriend as they were a man they had just met."
Yarnall believes it is important to recognize and understand predictors of unprotected sex so clinicians can identify and counsel women who may not see themselves at risk for sexually transmitted diseases. "Once we identify at-risk women, we should refer them for appropriate testing, follow-up counseling and education," she said.
Women’s Health Weekly
The Centers for Disease Control and Prevention Release the "Sexually Transmitted Disease Surveillance, 2002"
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update. Visit the CDC's website to find out more about their activities, publications and services.