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Predictors of repeat Chlamydia trachomatis and/or Neisseria gonorrhoeae infections among African-American adolescent women
  1. Andrea Swartzendruber,
  2. Jessica M Sales,
  3. Jennifer L Brown,
  4. Teaniese Latham Davis,
  5. Ralph J DiClemente,
  6. Eve Rose
  1. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
  1. 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}


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 (NCT00279799)

  • Adolescent
  • Chlamydia Trachomatis
  • Gonorrhoea

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