The protective value of school enrolment against sexually transmitted disease: a study of high-risk African American adolescent females
- Richard A Crosby1,
- Ralph J DiClemente2,
- Gina M Wingood2,
- Laura F Salazar2,
- Eve Rose2,
- Jessica M Sales2
- 1College of Public Health University of Kentucky, Kentucky, USA
- 2Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Correspondence to: Dr R Crosby College of Public Health, 121 Washington Avenue, Lexington, KY 40506-0003, USA;
- Accepted 6 October 2006
Objective: To identify whether school enrolment is protective against laboratory-confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors.
Methods: A cross-sectional study of 715 African-American adolescent females (15–21 years old) was conducted. Data collection included an audio-computer-assisted self-interview lasting about 60 min and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae.
Results: In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance.
Conclusion: This study provides initial evidence suggesting that keeping high-risk African-American adolescent females in school (including forms of school that occur after high-school graduation) may be important from a public health standpoint.
Funding: This study was supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health (R01 MH061210) to RJD and GMW.
Competing interests: None declared.
Study implementation and oversight was conducted by RJD, GMW JM-S and ER. RAC and LFS analysed the data and interpreted the findings. RAC, LFS and RJD conceived the analyses and prepared the manuscript.