Associations of sociodemographic, psychosocial, and behavioral factors with sexual risk and sexually transmitted diseases in teen clinic patients.
PURPOSE: To examine the influence of sociodemographic characteristics, sexually transmitted disease (STD)/human immunodeficiency virus knowledge, and psychosocial and behavioral risk factors on sexual risk and STDs in adolescents using constructs from the Information, Motivation, and Behavioral Skills model (IMB). METHODS: A convenience sample of 303 sexually experienced, racially diverse adolescents (mean age 16.7 years, 57.9% female) who were seeking health care at a general health maintenance organization teen clinic were recruited for the study and completed a self-reported questionnaire which assessed sociodemographic, knowledge, and psychosocial factors, risk behaviors, and history of STDs. Multiple regression analyses were used to assess factors associated with sexual risk behavior and STD history. RESULTS: Many of the study participants were at risk for STDs; 43.8% had four or more lifetime sexual partners, 62.8% did not consistently use condoms, 21.1% had a history of pregnancy or impregnation, and 28.2% had a history of STDs. A multiple linear regression model to assess factors associated with sexual risk behavior (a nine-item index) indicate that perceptions of higher STD risk, perceptions that friends engage in risk behaviors, perceptions that friends will not support their STD risk-reduction efforts, knowing someone of a similar age who has had an STD, and having no intention of using condoms in the future are significantly associated with sexual behavioral risk (R(2) =.22, p <.000). A logistic regression model to examine history of STDs reveals that teens who are female, African-American, frequently use marijuana, have an older steady sexual partner, have a history of pregnancy or impregnation, have a greater number of lifetime sexual partners, and perceive that monogamy will not decrease STD risk are significantly more likely to report a history of STDs. CONCLUSIONS: Sociodemographic factors and constructs of the IMB model are associated with adolescents' risk and acquisition of STDs. Teens with such risk profiles should be targeted for risk-reduction intervention.