Predictors of Repeat Chlamydia trachomatis and/or Neisseria gonorrhoeae Infections Among African-American Adolescent Females

• Authors: Andrea Swartzendruber, Emory University; Jessica Sales, Emory University; Jennifer L. Brown, Emory University; Teaniese P. Latham Davis, Emory University; Ralph Joseph Diclemente, Emory University; Eve Rose, Emory University
• Journal Title: Sexually Transmitted Infections
• Volume: Volume 89, Number 1
• Publisher: BMJ Publishing Group | 2013-02, Pages 76-82
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1136/sextrans-2012-050530
• Subjects: Health Sciences, Public Health
• Keywords: Adolescent; Chlamydia trachomatis; Gonorrhoea

Abstract

Background Young African-American women have the highest rates of Chlamydia trachomatis and Neisseria gonorrhoeae in the United States. The objective was to identify baseline predictors of repeat Chlamydia and/or gonorrhoea infections among African-American adolescent females. Methods Sociodemographic, psychosocial and behavioural data were collected at baseline and every 6 months for 2 years from 701 African-American females (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 and 1 (2%) at three follow-up visits. Controlling for age and intervention condition, impulsivity (AOR: 1.71, p=.018) was associated with an increased likelihood and having a boyfriend (AOR: 0.21, p=.006) a decreased likelihood of repeat infection. Conclusions Repeat Chlamydia and/or gonorrhoea infections are common among African-American adolescent females. 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 high numbers of repeat infections after receipt of an evidence-based intervention, enhanced screening and treatment services for young men may be warranted.