Original article
Correlates of using dual methods for sexually transmitted diseases and pregnancy prevention among high-risk african-american female teens

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Abstract

Purpose: To identify correlates of consistent dual-method use among African-American female adolescents at risk of sexually transmitted diseases (STDs) and pregnancy.

Methods: A convenience sample of 522 sexually active female teens attending adolescent medicine clinics, health department clinics, and school health classes volunteered. Recruitment sites were in low-income neighborhoods of Birmingham, Alabama. Adolescents completed a questionnaire and a face-to-face interview and provided vaginal swab specimens for laboratory diagnosis of STDs. Those reporting use of condoms and at least one other method of contraception, for each of the last five occasions they had sex were classified as consistent dual-method users. The questionnaire assessed frequency of adolescents’ communication with their parents and partners about sex. The questionnaire also assessed two measures of parental supervision and adolescents’ desire to avoid pregnancy. Multiple logistic regression assessed the independent contribution of each correlate of consistent dual-method use.

Results: Seventy-one adolescents (13.6%) were classified as consistent dual-method users. A strong desire to avoid pregnancy was the most influential correlate of consistent dual-method use [odds ratio (OR) =2.3]. Adolescents reporting that their parents generally knew whom they were with (OR = 2.0) and those reporting more frequent communication with parents (OR = 1.9) were also more likely to be consistent dual users.

Conclusions: The findings suggest the need for research to examine the efficacy of interventions building on adolescent females’ desire to avoid pregnancy. Study findings also suggest that interventions promoting improved parent–adolescent communication and improved parental supervision may contribute to adolescents’ use of dual methods for STD and pregnancy prevention.

Section snippets

Study sample

From December 1996 through April 1999, project recruiters screened 1130 female teens in adolescent medicine clinics, health department clinics, and school health classes to assess eligibility for participating in an HIV/STD prevention trial. Recruitment sites were in neighborhoods of Birmingham, Alabama, characterized by high rates of unemployment, substance abuse, violence, and STDs. The current study consists of 522 eligible adolescents who completed baseline assessments. Adolescents were

Characteristics of the sample

Average age of the adolescents was 16.0 years [standard deviation (SD) = 1.2]. Past STD was reported by 25.7% of the adolescents and 28.2% tested positive in this study for C. trachomatis, N. gonorrhoeae, or T. vaginalis. A history of pregnancy was reported by 40.2% of the adolescents, of whom 11.5% were currently pregnant. Of those reporting a history of STD, 63% also reported ever being pregnant. About 8% reported sex with only a casual partner(s) and 10.0% reported sex with both steady and

Discussion

Findings from this investigation indicate that desire to avoid pregnancy and two forms of parental involvement were important correlates of consistent dual-method use among adolescent females. Consistent dual-method use appears to be motivated by pregnancy concerns as opposed to concern about disease prevention. Findings clearly support the value of parental monitoring: that is, knowing whom their teenager is with when not at home or in school. This finding adds to a growing body of evidence

Acknowledgements

This study was supported by a grant from the Center for Mental Health Research on AIDS, National Institute of Mental Health (1R01 MH54412), to the second author. Drs. Crosby and Sionean were supported through an Association of Teachers of Preventive Medicine/CDC STD Prevention Fellowship. Dr. Cobb was supported by a postdoctoral fellowship from the Nell Hodgson Woodruff School of Nursing, Emory University. The authors thank Dr. Jane R. Schwebke for provision of cultures for T. vaginalis and Kim

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