Factors associated with self-reported STDs: data from a national survey

STD prevention programs need to identify population subgroups and risk behaviors that are associated with higher rates of disease.

To see what levels of STD experience were reported by respondents to a national survey and what factors were associated with self-reported STDs.

The survey data are from Cycle IV (1988) of the National Survey of Family Growth (NSFG), a nationally representative household-based sample of 8450 women ages 15 to 44 years. We examined characteristics of survey respondents who reported STD experience, characteristics of STD cases reported to the national STD surveillance system, and factors related to self-reported STDs using multiple logistic regression.

The self-reported survey data indicate that the majority of respondents who ever had gonorrhea (55%) were white, but white women account for only 19% of the annual cases in the surveillance system. Logistic regression analysis of survey data indicates factors associated with reported gonorrhea experience, sexual behavior, race/ethnicity, socioeconomic background, perceived risk of AIDS, receiving birth control education, and region of residence. Reporting of chlamydia appears to be strongly related to knowledge of this infection.

Because of basic differences in the statistics being compared, we cannot rule out other explanations. Our results suggest that the surveillance data may reflect underreporting of higher socioeconomic groups making use of private health care. Survey data, on the other hand, are probably affected by underreporting of STD experience. Questions to measure STD experience, treatment, and source of care on surveys of this type would greatly increase the understanding of STDs in the national population.