Predictors of repeat Chlamydia trachomatis and/or Neisseria gonorrhoeae infections among African-American adolescent women
- Andrea Swartzendruber,
- Jessica M Sales,
- Jennifer L Brown,
- Teaniese Latham Davis,
- Ralph J DiClemente,
- Eve Rose
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Correspondence to Dr Andrea Swartzendruber, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, 1518 Clifton Road, Atlanta, GA 30322, USA; alswart{at}emory.edu
- Received 15 February 2012
- Revised 7 November 2012
- Accepted 11 November 2012
- Published Online First 12 December 2012
Abstract
Background Young African-American women have the highest rates of Chlamydia trachomatis and Neisseria gonorrhoeae in the USA. The objective was to identify baseline predictors of repeat chlamydia and/or gonorrhoea infections among African-American adolescent women.
Methods Sociodemographic, psychosocial and behavioural data were collected at baseline and every 6 months for 2 years from 701 African-American women (14–20 years) enrolled in an HIV prevention trial. Vaginal swabs were self-collected at each visit and assayed for chlamydia and gonorrhoea using DNA amplification. Among participants testing positive for chlamydia and/or gonorrhoea at baseline, logistic regression analyses assessed baseline predictors of repeat infection.
Results Of 618 (88%) participants with ≥1 follow-up assessment, 123 (20%) had a positive chlamydia and/or gonorrhoea test result at baseline; 49 (40%) had a repeat infection during the study period. Of those with a repeat infection, 30 (61%) were positive at one follow-up visit, 18 (37%) at two visits and 1 (2%) at three follow-up visits. Controlling for age and intervention condition, impulsivity (AOR: 1.71, p=0.018) was associated with an increased likelihood, and having a boyfriend (AOR: 0.21, p=0.006) was associated with a decreased likelihood of repeat infection.
Conclusions Repeat chlamydia and/or gonorrhoea infections are common among African-American adolescent women. Among young African-American women who test positive for chlamydia and/or gonorrhoea, tailored interventions for more impulsive adolescents and those not in a relationship may reduce risk of repeat infections. Given the high numbers of repeat infections after receipt of an evidence-based intervention, enhanced screening and treatment services for young men may be warranted.
Clinical Trials Registration http://www.clinicaltrials.gov (NCT00279799)
