Dating Violence Link to STDs
Approximately 1 in 3 girls (31.5%) in grades 9–12 who reported sexual activity also reported sexual or physical violence from their dating partners in a study of 1,641 girls, reported Michele R. Decker of Harvard School of Public Health, Boston, and her colleagues (Pediatrics 2005;116:e272–6). A similar number (32.9%) reported being tested for an STD or HIV. Overall, girls who reported physical and sexual violence or physical violence alone were significantly more likely to be tested for an STD (odds ratio 2.4 or 1.6, respectively) than were girls who did not report any violence. In addition, the odds of a positive diagnosis were significantly higher for girls reporting physical and sexual violence or physical violence alone (odds ratio 2.6 or 2.2, respectively) compared with girls who did not report any violence. The study was limited by several factors, including possible underreporting of testing behaviors.
Predicting STI Risk in Teens
Teenagers who thought that their parents would strongly disapprove of their having sex were less likely to have developed sexually transmitted infections 6 years later, said Carol A. Ford, M.D., of the University of North Carolina at Chapel Hill, and her associates. The study included data on 11,594 adolescents from the National Longitudinal Study of Adolescent Health, a prospective cohort study initiated in 1995 when the participants were in grades 7–12 (Arch. Pediatr. Adolesc. Med. 2005; 159:657–64). Approximately half (52.8%) of the subjects were female, and the mean age at follow-up was 22 years. Overall, 5.5% of adolescents who thought that their parents strongly disapproved of sex during adolescence tested positive for Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis, compared with 8.0% and 8.9%, respectively, of those who thought that their parents' disapproval was moderate or low. In a bivariate analysis, factors associated with an increased likelihood of sexually transmitted infections included low grade point average, a perception of looking younger than one's peers, and a higher average daily school attendance rate. However, in a stratified, multivariate analysis, family, school, and individual factors associated with prolonged virginity—such as a high grade point average, working at least 20 hours per week, and attending a parochial school—were not predictive of STI status among boys at follow-up.
Knowledgeable but Not Using It
Adolescent girls at high risk for pregnancy and sexually transmitted infections who participated in a recent study were knowledgeable about common birth control methods, but most reported having unprotected sex.
Of 332 girls aged 12–18 from a cohort with a high rate of pregnancy and sexually transmitted infections, 90% were aware of major birth control methods, including condoms and hormonal contraceptives. The majority (84%) knew that condoms could help prevent sexually transmitted infections, but only 66% reported using a male or female condom the last time they had vaginal intercourse. Only 43% used condoms each of the last five times they had vaginal intercourse, Ligia Peralta, M.D., of the University of Maryland, Baltimore, reported in a poster at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology in New Orleans.
As for the use of hormonal contraceptives, 56% of 87 girls who used them said they use a long-acting injectable, 23% said they use a contraceptive patch, and 18% said they use OCs. More than 70% said they would use combined, user-controlled hormonal contraceptives in the next 6 months, with the patch being the most popular choice (30% of respondents).
Hepatitis Rates Decline
The incidence of hepatitis dropped from 35% to 19% among children aged 2–18 years between a baseline period of 1990–1997 and 2003, said Annemarie Wasley, Sc.D., of the Centers for Disease Control and Prevention, Atlanta, and her colleagues. The greatest decline occurred among children aged 2–9 years (89%), followed by declines in children aged 10–18 years (83.7%) and children younger than 2 years (79.5%). Overall, 9 of the 10 states with the greatest declines in infection rates were states that had implemented hepatitis vaccination, which became widely available in 1995 (JAMA 2005;294:194–201). In an accompanying editorial, Pierre Van Damme, M.D., and Koen Van Herck, M.D., of the University of Antwerp, Belgium, said that given the proven existence of antibodies more than 10 years after vaccination, and the odds that antibodies will persist for more than 25 years after vaccination, boosters should be unnecessary for healthy people, and childhood immunizations can be reasonable for countries where hepatitis rates are declining (JAMA 2005;294:246–8).