Date of Award

Fall 1-6-2012

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Richard Rothenberg

Second Advisor

Dr. Michael P. Eriksen

Abstract

Background: Adolescents and young adults aged 15 to 24 acquire nearly half of all new STDs in the United States, yet they represent only 25% of the sexually active population. Young men and women in this age group have the highest rates of chlamydia, gonorrhea, and syphilis, especially in the African American population. Adolescent risk factors include having a history of pregnancy or STDs, being arrested or incarcerated, substance abuse, early sexual debut and having 4 or more lifetime sexual partners. Protective behaviors such as parental involvement, school enrollment, and consistent condom use have been associated with decreased incidence of STDs. The purpose of this study is to observe changes in adolescent behaviors and experiences that are known risk factors for acquiring sexually transmitted diseases. The aim is to identify the time at which STD prevention interventions may be administered most effectively. In addition, the study aims to identify relevant themes and content that may be useful in creating interventions targeted to different age groups and genders.

Methods: This study utilizes primary data collected between 1999 and 2003 by Dr. Rothenberg and colleagues for a community-based network study of low-income African American adolescents living in a working class neighborhood in Southwest Atlanta. Two descriptive analyses were conducted: a period analysis in which all participants ages 15 to 18 who completed any or all of three interviews were included; and a cohort analysis, which included only participants who completed three interviews and who were 15, 16, 17 or 18 years of age at the time of the first interview. Univariate analysis was used to describe each variable and the resulting frequencies and percentages were reported.

Results: In both period and cohort analyses, higher proportions of older adolescents (ages 17 and 18) reported engaging in risky behaviors including drinking alcohol, using marijuana, having sex and having multiple sexual partners, compared to younger adolescents (ages 15 and 16). Males reported higher proportions of engaging in risky behaviors than females, but also higher proportions of condom use. The proportion of participants diagnosed with one or more STDs decreased at each interview. In the cohort analysis, the proportion of participants who perceived their STD risk as “medium” or “high” increased over time.

Conclusions: The findings suggest that as adolescents mature they engage in a greater variety of risky behaviors known to have a positive association to STD diagnosis. Period analyses, which have usually been done to study the sexual behaviors of adolescents, may give aberrant results that are clearer when the population is studied as a cohort. Future studies are needed to more precisely identify the period during which adolescents experience rapid changes in their risk behaviors.

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