December 11, 2009
A new study of young urban women found many acquired an STD shortly after sexual debut, while STD screening typically begins years later. And a companion study found the "Horizons HIV Intervention" curbed risky behavior among young urban African-American females.
In the first, eight-year study, 386 girls ages 14-17 at baseline were enrolled from three adolescent medicine clinics. By age 15, 25 percent of participants had acquired at least one of three STDs for which they were screened, most often chlamydia.
The median interval between first intercourse and first STD diagnosis was two years. Within one year of intercourse, 25 percent had acquired their first chlamydia infection. The study also screened for gonorrhea and Trichomoniasis vaginalis.
"Repeated infections were very common," said Dr. Wanzhu Tu of the Indiana University School of Medicine. "Within four to six months (depending on the organism) after treatment of the previous infection, a quarter of the women were re-infected with the same organism."
"These young women are vulnerable to STIs, but because of their younger age, they may not be perceived by health care providers as having STI risk, and thus are not screened in a timely manner," Tu said. "For urban adolescent women, STI screening (especially for chlamydia) should begin within one year after first intercourse and infected individuals should be retested frequently, preferably every three to four months."
The Horizons study involved 715 African-American females ages 15-21 who were recruited from reproductive health clinics in Atlanta. The Horizons intervention consisted of two four-hour, group-based sessions and four telephone contacts over a 12-month period. The program targeted personal, relational, sociocultural and structural HIV/STD risk factors, and participants were given vouchers facilitating partner STD screening and treatment.
The Horizons program reduced first and recurrent chlamydia infection and led to higher reports of condom use. In addition, it led to a decrease in douching, which has been linked to risk of STD infection.
The studies, "Time from First Intercourse to First Sexually Transmitted Infection Diagnosis Among Adolescent Women" and "Efficacy of Sexually Transmitted Disease/Human Immunodeficiency Virus Sexual Risk-Reduction Intervention for African American Adolescent Females Seeking Sexual Health Services," were published in Archives of Pediatrics & Adolescent Medicine (2009;163(12):1106-1111 and 1112-1121).