Date of Award

Winter 12-15-2011

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Richard Rothenberg, M.D.

Second Advisor

Laura Salazar, Ph.D.

Abstract

STDs are a major public health epidemic in the United States with an estimated 19 million new cases occurring annually. Associated direct medical costs are estimated at $17 billion annually (CDC, 2010). Chlamydia is the most prevalent of all STDs and is also the most reported notifiable disease in the United States. While adolescents only account for an estimated 25% of the sexually active population, they account for nearly half of the 19 million cases. The higher prevalence of STDs among adolescents is most likely a reflection of multiple issues within a national socio-economic context. Additionally, the burden is even more disproportionate when examined by race. African American adolescents aged 15-19 experience the greatest burden of STDs. The purpose of this study is to examine proportions of risk behaviors reported among groups and the differences that are found. From the estimation of differences that were determined substantial, an analysis of was conducted in order to determine if adolescents in the study population exhibit clustering in regard to risk behaviors for STD acquisition and describe the where the potential clustering occurs as well as identify which factors that may serve as important indicators for STD positivity among this population. This paper examines data that was collected as part of a National Institute of Health grant-funded project entitled: “Behavioral Clustering in Adolescents with STDs”, conducted by Dr. Richard Rothenberg, Principal Investigator. This paper presents descriptive statistics for selected behavioral characteristics for four groups from the original study and each group’s contacts. The proportions for each characteristic are also analyzed for to see if behavioral clustering occurs within and between groups. The scope of this paper does not allow for the statement of conclusive results however, substantial differences did exist for variables among each sub group. Comparing data by group cluster and interview type proved to reveal the most about the study population. Negative males and their contacts may have extensive clustering as this group was only found to have substantial differences for two variables. Comparison of the positive and negative ego groups for both males and females also indicated clustering as only two (ego females) and three (ego males) variables were found to be substantially different. Proportions for variables regarding education, incarceration, sexual initiation, and number of partners were compared between several groupings of the study population. This paper recommends further analysis of the data in order to identify the patterns of assortativity which will be valuable in understanding the STD transmission dynamics among the social and sexual networks of the adolescents in the study population as well as have important implications on future research.

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