A descriptive analysis of STD prevalence among urban pregnant African-American teens: data from a pilot study

To assess the prevalence of sexually transmitted diseases (STDs) among a sample of African-American adolescent females at the time of their first prenatal visit and to assess key characteristics of those testing positive for sexually transmitted diseases. The study also determined differences in these characteristics between adolescents who were and those who were not diagnosed with an STD.

One-hundred-and-seventy pregnant African-American adolescents (aged 14-20 years; mean = 17.5 years) receiving their first prenatal visit were recruited at a prenatal clinic located in a large urban hospital. Biological assessment included nucleic acid amplification testing for gonococcal, chlamydial, and trichomonal infections. Rapid plasma reagin testing assessed infection with syphilis. A self-administered survey and in-depth face-to-face interview were used to collect detailed information assessing adolescents' sociodemographic characteristics, psychosocial indices, and their recent sexual risk behaviors. Data were analyzed using Student's t-tests and contingency table analyses, respectively, for continuous and categorical variables.

Overall, 23.5% tested positive for one of the four STDs. Thirteen percent were infected with Chlamydia trachomatis, 1.2% with Neisseria gonorrhoeae, 8.9% with Trichomonas vaginalis, and 1.2% with Treponema pallidum. More than one-half reported recent (past 6 months) treatment for an STD, 30% of these tested positive for at least one of the four STDs assessed. Adolescents testing positive for STDs held favorable attitudes toward condom use, but levels of sexual risk were generally high. There were no sociodemographic, psychosocial, and sexual-risk differences between those testing positive and negative.

Findings support STD screening efforts targeting pregnant adolescents. Providing clinic-based counseling and prevention education programs to pregnant adolescents regardless of apparent risk factors may also be warranted.