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A Partner-Related Risk Behavior Index to Identify People at Elevated Risk for Sexually Transmitted Infections

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Abstract

The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio—computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4 %) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p < .001). In the presence of three covariates (gender, race, and age), those classified as being at-risk by the index were 1.8 times more likely than those not classified as such to test positive for an STI (p < .001). Among individuals at risk for STIs, a three-item index predicted testing positive for one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.

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References

  • Aral, S. O., Lipshutz, J. A., & Douglas, J. M. (2007). Introduction. In S. O. Aral, J. M. Douglas, J. A. Lipshutz (Eds.), Behavioral interventions for the prevention and control of sexually transmitted diseases (pp. ix-xix). New York, NY: Springer.

  • Carroll, K. C., Aldeen, W. E., Morrison, M., Anderson, R., Lee, D., & Mottice, S. (1998). Evaluation of the Abbott LCx ligase chain reaction assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine and genital swab specimens from a sexually transmitted disease clinic population. Journal of Clinical Microbiology, 36, 1630–1633.

    PubMed  CAS  Google Scholar 

  • Centers for Disease Control and Prevention. (2010a). Establishing a holistic framework to reduce inequities in HIV, viral hepatitis, STDs, and tuberculosis in the United States. Atlanta, GA: US Department of Health and Human Services.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2010b). Sexually transmitted diseases surveillance, 2009. Atlanta, GA: US Department of Health and Human Services.

    Google Scholar 

  • Crosby, R. A., DiClemente, R. J., Wingood, G. M., Lang, D., & Harrington, K. F. (2003). Value of consistent condom use: A study of sexually transmitted disease prevention among African American adolescent females. American Journal of Public Health, 93, 901–902.

    Article  PubMed  Google Scholar 

  • Crosby, R. A., DiClemente, R. J., Wingood, G. M., Sionean, C., Cobb, B. K., Harrington, K. F., et al. (2002). Correlates of casual sex among African-American female teens. Journal of HIV/AIDS Prevention & Education for Adolescents and Children, 4(4), 55–67.

    Article  Google Scholar 

  • Crosby, R. A., Salazar, L. F., DiClemente, R. J., & Yarber, W. L. (2004). Correlates of having unprotected vaginal sex among detained adolescent females: An exploratory study of sexual factors. Sexual Health, 1, 151–155.

    Article  PubMed  Google Scholar 

  • Crosby, R. A., Salazar, L. F., DiClemente, R. J., Yarber, W. L., Caliendo, A. M., & Staples-Horne, M. (2005). Accounting for failures may improve precision: Evidence supporting improved validity of self-reported condom use. Sexually Transmitted Diseases, 32, 513–515.

    Article  PubMed  Google Scholar 

  • De, P., Singh, A., Wong, T., & Kaida, A. (2007). Predictors of gonorrhea reinfection in a cohort of sexually transmitted disease patients in Alberta, CA, 1991–2003. Sexually Transmitted Diseases, 34, 30–36.

    Article  PubMed  Google Scholar 

  • DiClemente, R. J., Salazar, L. S., Crosby, R. A., & Rosenthal, S. L. (2005a). Prevention and control of sexually transmitted infections among adolescents: The importance of a socio-ecological perspective—a commentary. Public Health, 119, 825–836.

    Article  PubMed  CAS  Google Scholar 

  • DiClemente, R. J., Wingood, G. M., Lang, D. L., Crosby, R. A., Salazar, L. F., Harrington, K., et al. (2005b). Adverse health consequences that co-occur with depression: A longitudinal study of black adolescent females. Pediatrics, 116, 78–81.

    Article  PubMed  Google Scholar 

  • DiClemente, R. J., Wingood, G. M., Sionean, C., Crosby, R. A., Harrington, K., Davies, S., et al. (2002). Association of adolescents’ history of sexually transmitted disease (STD) and their current high-risk behavior and STD status: A case for intensifying clinic-based prevention efforts. Sexually Transmitted Diseases, 29, 503–509.

    Article  PubMed  Google Scholar 

  • Gorbach, P. M., Stoner, B. P., Aral, S. O., Whittington, W. L., & Holmes, K. K. (2002). “It takes a village”: Understanding concurrent sexual partnerships in Seattle, Washington. Sexually Transmitted Diseases, 29, 453–462.

    Article  PubMed  Google Scholar 

  • Kaydos, S. C., Swygard, H., Wise, S. L., Sena, A. C., Leone, P. A., Miller, W. C., et al. (2002). Development and validation of a PCR-based enzyme-linked immunosorbent assay with urine for use in clinical research settings to detect Trichomonas vaginalis in women. Journal of Clinical Microbiology, 40, 89–95.

    Article  PubMed  CAS  Google Scholar 

  • Kaydos-Daniels, S. C., Miller, W. C., Hoffman, I., Banda, T., Dzinyemba, W., Martinson, F., et al. (2003). Validation of a urine-based PCR-enzyme-linked immunosorbent assay for use in clinical research settings to detect Trichomonas vaginalis in men. Journal of Clinical Microbiology, 41, 318–323.

    Article  PubMed  CAS  Google Scholar 

  • Koumans, E. H., Farley, T. A., Gibson, J. J., Langley, C., Ross, M. W., McFarlane, M., et al. (2001). Characteristics of persons with syphilis in areas of persisting syphilis in the United States: Sustained transmission associated with concurrent partnerships. Sexually Transmitted Diseases, 28, 497–503.

    Article  PubMed  CAS  Google Scholar 

  • Mehta, S. D., Erbelding, E. J., Zenilman, J. M., & Rompalo, A. M. (2003). Gonorrhea reinfection in heterosexual STD clinic attendees: Longitudinal analysis of risks for first reinfection. Sexually Transmitted Infections, 79, 124–128.

    Article  PubMed  CAS  Google Scholar 

  • Mertz, K. J., Finelli, L., Levine, W. C., Mognoni, R. C., Berman, S. M., Fishbein, M., et al. (2000). Gonorrhea in male adolescents and young adults in Newark, New Jersey: Implications of risk factors and patient preferences for prevention strategies. Sexually Transmitted Diseases, 27, 201–207.

    Article  PubMed  CAS  Google Scholar 

  • Peterman, T. A., Lin, L. S., Newman, D. R., Kamb, M. L., Bolan, G., Zenilman, T., et al. (2000). Does measured behavior reflect STD risk? An analysis of data from a randomized controlled behavioral intervention study. Project RESPECT study group. Sexually Transmitted Diseases, 27, 446–451.

    Article  PubMed  CAS  Google Scholar 

  • Rosenberg, M. D., Gurvey, J. E., Adler, N., Dulop, M. B., & Ellen, J. M. (1999). Concurrent sex partners and risk for sexually transmitted diseases among adolescents. Sexually Transmitted Diseases, 26, 208–212.

    Article  PubMed  CAS  Google Scholar 

  • Salazar, L. F., Crosby, R. A., DiClemente, R. J., Wingood, G. M., Rose, E., McDermott-Sales, J., et al. (2009). African-American female adolescents who engage in oral, vaginal and anal sex: “Doing it all” as a significant marker for risk of sexually transmitted infection. AIDS and Behavior, 13, 85–93.

    Article  PubMed  Google Scholar 

  • Salazar, L. F., Crosby, R. A., DiClemente, R. J., Wingood, G. M., Rose, E., Sales, J. M., et al. (2007). Personal, relational, and peer-level risk factors for laboratory confirmed STD prevalence among low-income African American adolescent females. Sexually Transmitted Diseases, 34, 761–766.

    PubMed  Google Scholar 

  • Thomas, J. C., Weiner, D. H., Schoenbach, V. J., & Earp, J. A. (2000). Frequent re-infection in a community with hyperendemic gonorrhea and chlamydia: Appropriate clinical actions. International Journal of STD and AIDS, 11, 461–467.

    Article  PubMed  CAS  Google Scholar 

  • Turner, C. F., Ku, L., Rogers, S. M., Lindberg, L. D., Pleck, J. H., & Sonenstein, F. L. (1998). Adolescent sexual behavior, drug use, and violence: Increased reporting with computer survey technology. Science, 280, 867–873.

    Article  PubMed  CAS  Google Scholar 

  • Warner, L., Macaluso, M., Austin, H. D., Kleinbaum, D. K., Artz, L., Fleenor, M. E., et al. (2005). Application of the case-crossover design to reduce unmeasured confounding in studies of condom effectiveness. American Journal of Epidemiology, 161, 765–773.

    Article  PubMed  Google Scholar 

  • Warner, L., Newman, D. R., Austin, H. D., Kamb, M. L., Douglas, J. M., Malotte, C. K., et al. (2004). Condom effectiveness for reducing transmission of gonorrhea and chlamydia: The importance of assessing partner infection status. American Journal of Epidemiology, 159, 242–251.

    Article  PubMed  Google Scholar 

  • Warner, L., Stone, K. M., Macaluso, M., Buehler, J., & Austin, H. D. (2006). Condom use and risk of gonorrhea and chlamydia: A systematic review of design and measurement factors assessed in epidemiologic studies. Sexually Transmitted Diseases, 33, 36–51.

    Article  PubMed  Google Scholar 

  • Zenilman, J. M., Weisman, C. S., Rompalo, A. M., Ellish, N., Upchurch, D. M., Hook, E. W., 3rd, et al. (1995). Condom use to prevent incident STDs: The validity of self-reported condom use. Sexually Transmitted Diseases, 22, 15–21.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

Support for this project was provided by a grant to the first author from the National Institute of Allergies and Infectious Diseases, grant #5 R01 AI068119.

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Authors and Affiliations

  1. College of Public Health, University of Kentucky, 121 Washington Ave., Lexington, 40506-0003, KY, USA

    Richard Crosby

  2. Rural Cancer Prevention Center, University of Kentucky, Lexington, KY, USA

    Richard Crosby

  3. The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA

    Richard Crosby

  4. Division of Adolescent/Young Adult Medicine, Children’s Hospital Boston, Boston, MA, USA

    Lydia A. Shrier

  5. Department of Pediatrics, Harvard Medical School, Waltham, MA, USA

    Lydia A. Shrier

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  1. Richard Crosby
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  2. Lydia A. Shrier
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Correspondence to Richard Crosby.

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Crosby, R., Shrier, L.A. A Partner-Related Risk Behavior Index to Identify People at Elevated Risk for Sexually Transmitted Infections. J Primary Prevent 34, 81–87 (2013). https://doi.org/10.1007/s10935-013-0290-7

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