Prevalence of bacterial vaginosis (BV) by Nugent’s criteria in a non-clinic national sample of young women entering the military: relationships with sexual experience, vaginal symptoms and signs

Abstract

rency, partners having more than one partner during a time period, has been found to increase the risk of STIs. Purpose: To determine whether the association of sex partner concurrency and risk for current STIs varies by STI prevalence in geographic areas among female adolescents in Baltimore City. Methods: Sexually active 14–19 year olds were recruited for a longitudinal study between August 2000 and June 2002 from two urban clinics. Trained interviewers conducted face-to-face structured interviews eliciting information on participants and their most recent main sex partner. Urine specimens were collected for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) LCR testing. Each participant’s primary residential address was geocoded to a Census 2000 census block group. STD surveillance information from 1994–1999 of gonorrhea case rates per census block group per 15–39 year olds per 100,000 were linked to the participant’s census block group information. Univariate associations between current CT and/or GC infection and sex partner concurrency and gonorrhea rate (categorized into 25th percentiles) in the participant’s census block group were conducted on baseline information. Logistic regression was used to estimate the odds ratio of CT and/or GC infection of the participant (dependent) associated with the main effects of and interactions between sex partner concurrency and STI prevalence in geographic areas. Results: Univariate associations between CT and/or GC infection were not significant for sex partner concurrency and gonorrhea rate per census block group. However, multivariate logistic regression identified concurrency and an interaction between concurrency and STI prevalence in geographic areas as being significantly associated with current CT and/or GC infection. The interaction showed that among participants living in high prevalence geographic areas, having a concurrent sex partner was significantly associated with a current STI. Among participants living in low prevalence geographic areas, having a concurrent sex partner was not significantly associated with current STI in the index participant. Conclusions: The results show geographic context and sex partner concurrency have combined effects on current STI risk. The literature holds that sex partner behaviors are associated with risk of acquiring an STI, however, our results suggest an adolescent’s geographic context moderates the effect of partner behaviors. Our research adds to the basic understanding of STD transmission and acquisition in a high prevalence inner city. Further research is warranted into the effect of geography on STI acquisition.