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Emerging adulthood often entails heightened risk-taking with potential life-long consequences, and research on risk behaviors is needed to guide prevention programming, particularly in under-served and difficult to reach populations. This study evaluated the utility of Respondent Driven Sampling (RDS), a peer-driven methodology that corrects limitations of snowball sampling, to reach at-risk African American emerging adults from disadvantaged urban communities. Initial "seed" participants from the target group recruited peers, who then recruited their peers in an iterative process (110 males, 234 females; M age = 18.86 years). Structured field interviews assessed common health risk factors, including substance use, overweight/obesity, and sexual behaviors. Established gender-and age-related associations with risk factors were replicated, and sample risk profiles and prevalence estimates compared favorably with matched samples from representative U.S. national surveys. Findings supported the use of RDS as a sampling method and grassroots platform for research and prevention with community-dwelling risk groups.

Objectives: Identifying sexual risk patterns associated with HIV/sexually transmitted infections (STI) and early parenthood within population subgroups is critical for targeting risk reduction interventions., Methods: Latent Class Analysis (LCA) was used to identify sexual behaviour typologies to predict sexual risk outcomes among 274 (63% female) unmarried, sexually active African-American emerging adults (M age=19.31 years) living in disadvantaged urban neighbourhoods. Participants were enrolled in a larger cross-sectional observational study of risk and protective behaviours. LCA defined membership into discrete risk classes based on reported sex risk behaviours., Results: Three groups were identified: The 'low contraception use' risk class (32%) had low rates of condom or other birth control use, moderate rates of sexual initiation before age 16 years, and the highest pregnancy/early parenthood and STI rates. The predominately male 'early sex' risk class (32%) had higher rates of early initiation and multiple partners, risks that were countered by higher contraception and condom use. Both these risk groups showed higher probability to use substances before sex relative to the 'low sex risk' class (36%), which showed low rates on all risk behaviours., Conclusions: LCA identified distinct risk clusters that predicted sexual health outcomes and can inform targeted interventions for a minority youth population disproportionately affected by HIV, other STIs, and early parenthood., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: For many health-related behaviors and outcomes, racial and ethnic disparities among adolescents are well documented, but less is known about health-related disparities during preadolescence., Methods: We studied 5119 randomly selected public-school fifth-graders and their parents in three metropolitan areas in the United States. We examined differences among black, Latino, and white children on 16 measures, including witnessing of violence, peer victimization, perpetration of aggression, seat-belt use, bike-helmet use, substance use, discrimination, terrorism worries, vigorous exercise, obesity, and self-rated health status and psychological and physical quality of life. We tested potential mediators of racial and ethnic disparities (i.e., sociodemographic characteristics and the child's school) using partially adjusted models., Results: There were significant differences between black children and white children for all 16 measures and between Latino children and white children for 12 of 16 measures, although adjusted analyses reduced many of these disparities. For example, in unadjusted analysis, the rate of witnessing a threat or injury with a gun was higher among blacks (20%) and Latinos (11%) than among whites (5%), and the number of days per week on which the student performed vigorous exercise was lower among blacks (3.56 days) and Latinos (3.77 days) than among whites (4.33 days) (P<0.001 for all comparisons). After statistical adjustment, these differences were reduced by about half between blacks and whites and were eliminated between Latinos and whites. Household income, household highest education level, and the child's school were the most substantial mediators of racial and ethnic disparities., Conclusions: We found that harmful health behaviors, experiences, and outcomes were more common among black children and Latino children than among white children. Adjustment for socioeconomic status and the child's school substantially reduced most of these differences. Interventions that address potentially detrimental consequences of low socioeconomic status and adverse school environments may help reduce racial and ethnic differences in child health. (Funded by the Centers for Disease Control and Prevention.).

Women living with HIV are especially vulnerable to discrimination because of the stigma associated with the disease, as well as their race, gender and class status. To investigate the association between self-reported HIV discrimination and health outcomes among African- American and white women living with HIV, 366 women living with HIV were recruited from HIV/AIDS clinics in Georgia and Alabama. In this cross-sectional study, participants completed an interview that assessed self-reported HIV discrimination and depressive symptomatology, suicidal ideation, self-esteem, stress, quality of life, sexual health and HIV/AIDS related health care seeking. Nearly a sixth of the sample reported experiencing HIV discrimination. Women reporting HIV discrimination had higher mean scores for stress, suicidal ideation, depressive symptoms, number of unprotected sexual episodes; they had lower mean scores for self-esteem, and quality of life, and were more likely to have not sought medical care for HIV/AIDS. In race-specific analyses, none of the relationships between HIV discrimination and health outcomes were significant for white women. African-American women who reported HIV discrimination had higher mean scores for stress, suicidal ideation, depressive symptoms, number of unprotected sexual episodes; they had lower mean scores for self-esteem, and quality of life, and were more likely not to have sought medical care for HIV/AIDS. The findings indicated that HIV discrimination adversely affects women's mental, sexual and physical health. However, separate race-specific analyses indicated that compared to white women, African-American women were markedly more likely to experience the adverse affects of HIV discrimination. Eradication of HIV discrimination remains an important public health priority.

Purpose: To assess the independent effects of various behavioral and psychosocial antecedents on contraceptive use among a sample of low-income African-American adolescent females., Methods: Stepwise logistic regression was used to calculate odds ratios for baseline predictors of inconsistent contraceptive use six months later. Study participants include 375 nonpregnant African-American girls aged 14-18 years who reported sexual activity in the previous six months. Data were collected using a self-administered survey, individual interview and urine pregnancy test., Results: Adolescents who were inconsistent contraceptive users at follow-up were more likely to have reported a desire for pregnancy, previous inconsistent contraceptive use, less frequent communication with their partners about prevention issues, and an increased number of lifetime sexual partners at the baseline assessment. Of equal importance was the finding that a previous pregnancy or sexually transmitted infection did not influence future contraceptive behaviors., Conclusions: Clinicians can play an important role in counseling adolescents about sexual health and dispelling misperceptions that hinder consistent contraceptive use. Findings from this research could have significant implications for the development of effective sexually transmitted infection (STI) and pregnancy prevention programs for adolescents and can help in guiding clinicians toward relevant treatment practices.

Objectives: We examined the efficacy of an HIV prevention intervention among African American female adolescents reporting a history of gender-based violence., Methods: In this analysis of a subgroup of participants involved in a randomized controlled trial, consistent condom use, psychosocial mediators associated with HIV-preventive behaviors, and presence of sexually transmitted diseases were assessed at 6- and 12-month follow-ups. The intervention emphasized ethnic and gender pride, HIV knowledge, condom attitudes, healthy relationships, communication, and condom use skills., Results: Relative to the comparison condition, participants randomized to the intervention reported using condoms more consistently, had fewer episodes of unprotected vaginal sex, engaged in a greater proportion of protected intercourse acts, were more likely to have used a condom during their most recent intercourse, were less likely to have a new sexual partner, were less likely to have a sexually transmitted disease, and demonstrated more proficient condom skills., Conclusions: Given the substantial prevalence of gender-based violence among female adolescents and the associations observed between gender-based violence, HIV risk, and HIV infection, it is essential that HIV interventions involving young women address partner violence.

Objective: To evaluate the effectiveness of a smoking cessation intervention based on the transtheoretical model of change with a sample of low-income African American smokers admitted to an indigent-care hospital., Methods: The intervention incorporated components shown to be effective in increasing cessation in other populations, tailored to a bedside counseling format with follow-up contact postdischarge., Results: Intervention patients were significantly more likely to advance in stage than were control patients., Conclusion: A hospital-offered bedside intervention offers promise in reaching underserved smokers with effective, though limited, cessation assistance.

Objective: To qualitatively examine the perceptions of young fathers toward issues related to early childbearing., Methods: Focus groups were held with male partners of adolescent females who had become pregnant while participating in an HIV-prevention trial., Results: Primary domains that emerged included young male's desire for pregnancy, their attitudes toward father/child involvement, and their perceived social support as young fathers., Conclusions: Findings may help in developing gender-appropriate interventions to delay early childbearing and prevent HIV/STD transmission.

This study examined associations between African American adolescent girls' desire to become pregnant and their sexual and relationship practices. Odds ratios and 95% confidence intervals were used to detect significant associations between pregnancy desire and the assessed correlates. Of 522 participants (14 to 18 years old), 67 (12.8%) were pregnant and were thus excluded from this analysis. Of the remaining 455 adolescents, 107 (23.6%) expressed some desire to be pregnant at the time of assessment. Adolescents who desired pregnancy were significantly more likely to report having had sex with a casual partner and to use contraception inconsistently. Factors involving an adolescent girl's relationship with her partner (e.g., being in a relationship, length of relationship, time spent with boyfriend, or satisfaction with boyfriend) were not significantly associated with the desire for pregnancy. Effective pregnancy and sexually transmitted disease prevention programs for female adolescents should address their level of pregnancy desire.

Context: African American adolescent girls are at high risk for human immunodeficiency virus (HIV) infection, but interventions specifically designed for this population have not reduced HIV risk behaviors., Objective: To evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors., Design, Setting, and Participants: Randomized controlled trial of 522 sexually experienced African American girls aged 14 to 18 years screened from December 1996 through April 1999 at 4 community health agencies. Participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing. Outcome assessments were made at 6- and 12-month follow-up., Intervention: All participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition., Main Outcome Measures: The primary outcome measure was consistent condom use, defined as condom use during every episode of vaginal intercourse; other outcome measures were sexual behaviors, observed condom application skills, incident STD infection, self-reported pregnancy, and mediators of HIV-preventive behaviors., Results: Relative to the comparison condition, participants in the intervention reported using condoms more consistently in the 30 days preceding the 6-month assessment (unadjusted analysis, intervention, 75.3% vs comparison, 58.2%) and the 12-month assessment (unadjusted analysis, intervention, 73.3% vs comparison, 56.5%) and over the entire 12-month period (adjusted odds ratio, 2.01; 95% confidence interval [CI], 1.28-3.17; P =.003). Participants in the intervention reported using condoms more consistently in the 6 months preceding the 6-month assessment (unadjusted analysis, intervention, 61.3% vs comparison, 42.6%), at the 12-month assessment (unadjusted analysis, intervention, 58.1% vs comparison, 45.3%), and over the entire 12-month period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.50; P<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy., Conclusion: Interventions for African American adolescent girls that are gender-tailored and culturally congruent can enhance HIV-preventive behaviors, skills, and mediators and may reduce pregnancy and chlamydia infection.

Objective: To examine predicted relationships among transtheoretical model of change measures in a sample of 211 low-income, African American hospitalized smokers., Methods: We used discriminant analysis to examine differences in decisional balance and self-efficacy across stages of change for quitting., Results: Differences in decisional balance and self-efficacy were concurrent with stage differences. The function discriminated among all 3 stages with the clearest differences between precontemplation and preparation., Conclusion: Although results with this specialized sample are not generalizable, they add to the evidence that transtheoretical model of change variables are robust across populations.

Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.

Objective: To examine the prevalence and correlates of wanting to become pregnant among a sample of 462 sexually active nonpregnant African American adolescent females., Methods: Multivariate logistic regression was used to calculate adjusted odds ratios, their 95% confidence intervals, and respective P values., Results: Significant correlates with pregnancy desire included having a male partner who desired pregnancy, having a boyfriend at least 5 years older, having low self-esteem, perceiving greater perceived barriers to condom use, and perceiving low family support., Conclusions: Pregnancy prevention programs designed for economically disadvantaged African American adolescent females should address these correlates of their pregnancy desire.

Objective: To examine the association between gang involvement and female adolescents' health., Methods: African American adolescent females (N = 522) completed a survey that assessed their history of gang involvement and health behaviors and provided specimens that were analyzed for marijuana use and sexually transmitted diseases., Results: In logistic regression analyses, adolescents with a history of gang involvement were more likely to have been expelled from school (odds ratio [OR]: 3.6), be a binge drinker (OR: 3.3), have a positive toxicologic test for marijuana (OR: 2.6), have been in 3 or more fights in the past 6 months (OR: 3.8), have a nonmonogamous partner (OR: 2.4), and test positive for Trichomonas vaginalis (OR: 2.2) and Neisseria gonorrhoeae (OR: 3.6)., Conclusion: This study extends the current research on risk behaviors associated with gang involvement to include biological markers for substance use and sexual health outcomes, namely, marijuana use and sexually transmitted diseases.

Objectives: To identify psychosocial predictors of Trichomonas vaginalis infection among low income African-American adolescent females living in a high risk urban area of the United States., Methods: Baseline plus 6 and 12 month follow up data collected as part of an HIV prevention intervention trial were utilised. The baseline sample consisted of 522 African-American females, 14-18 years of age. Recruitment sites were located in low income neighbourhoods of Birmingham, Alabama, characterised by high rates of unemployment, substance abuse, violence, teenage pregnancy, and sexually transmitted infections. Self administered vaginal swab specimens were cultured for T vaginalis. Baseline measures collected as part of a self administered survey and face to face interviews were used to predict subsequent infection with T vaginalis at any of the three assessment periods conducted over the span of 1 year., Results: At baseline, 12.9% were diagnosed with T vaginalis. At the 6 and 12 month follow ups, T vaginalis was diagnosed in 8.9% and 10.2%, respectively. The strongest multivariate predictor of T vaginalis infection was biologically confirmed marijuana use; those using marijuana were more than six times as likely to test positive for T vaginalis (adjusted odds ratio (AOR) = 6.2, p = 0.0003). Other multivariate predictors were reporting that typical sex partners were at least 5 years older (AOR = 2.6; p = 0.005), reporting sex with non-steady partners (AOR = 1.9; p = 0.02), and history of delinquency (AOR = 1.3; p = 0.02). The odds of testing positive increased by 31% for every one unit increase on a six item scale measure of delinquency., Conclusions: Infection with T vaginalis was common and significant multivariate predictors comprised a constellation of problem behaviours, each of which are potentially amenable to behavioural intervention.

Background: Numerous studies have examined the association between adolescents' marijuana use and their high-risk sexual behaviors and sexually transmitted diseases (STDs). However, the validity of the findings is questionable because most of the studies relied on self-reporting for measurement of marijuana use and key outcome (i.e., STDs)., Goal: The goal was to investigate associations between biologically confirmed marijuana use and laboratory-confirmed STDs and condom use., Study Design: African American females adolescents (n = 522) completed a self-administered survey and face-to-face interview. The adolescents provided urine and vaginal swab specimens that were analyzed for marijuana metabolites and STDs, respectively., Results: Among the study subjects, 5.4% tested positive for marijuana. These adolescents were more likely to test positive for Neisseria gonorrhoeae (adjusted odds ratio [AOR] = 3.4) and Chlamydia trachomatis (AOR = 3.9). They were more likely to have never used condoms in the previous 30 days (AOR = 2.9) and to have not used condoms consistently in the previous 6 months (AOR = 3.6)., Conclusion: The findings represent unique biologic evidence that STDs and sexual risk behavior may co-occur with marijuana use. Interventions designed to reduce adolescents' risk of STDs and HIV infection should address marijuana use.

Objectives: This study examines the association between African American adolescent females' body image and their sexual health., Methods: African American adolescent females (n = 522) completed a survey that assessed body image using a 7-item scale (alpha = 0.71) and a face-to-face interview that assessed sexual behaviors., Results: In logistic regression analyses, controlling for depression, self-esteem and body mass index (BMI), adolescents who were more dissatisfied with their body image were more likely to fear abandonment as a result of negotiating condom use (adjusted odds ratio [AOR] = 3.3, p = 0.02), more likely to perceive that they had fewer options for sexual partners (AOR = 2.4, p = 0.001), more likely to perceive themselves as having limited control in their sexual relationships (AOR = 2.0, p = 0.002), and more likely to worry about acquiring HIV(AOR = 1.5, p = 0.04). There was an association between having a greater dissatisfaction with one's body image and never using condoms during sexual intercourse in the past 30 days (AOR = 1.6, p = 0.04) and more likely to engage in unprotected vaginal sex in the prior 6 months (AOR = 1.6, p = 0.04)., Conclusions: Prior research has demonstrated an association between African American women's body image and greater obesity risk, lower self-esteem, and greater depression. The present study has shown an association between body image dissatisfaction and a range of sexual attitudes, beliefs, and behaviors. Women who are more dissatisfied with their body image may be at greater risk for unintended pregnancy, sexually transmitted infections (STIs), and HIV infection.

Objective: The aim of this study was to prospectively compare pregnant and nonpregnant adolescents' recent condom use and sexually transmitted disease (STD) acquisition., Methods: Sexually active African-American females (N = 522), ages 14-18, were recruited from clinics and schools. Adolescents completed baseline interviews and provided vaginal swabs for STD testing, and urine for pregnancy testing. Assessments were repeated 6 and 12 months post baseline assessment. Analyses compared adolescents who became pregnant between baseline and the 6-month assessment with their peers who had negative pregnancy tests. Condom use between the 6- and 12-month assessments and incidence of STDs at the 12-month assessment served as outcomes. Adolescents who did not report sexual activity between the 6- and 12-month assessments were excluded., Results: Ten percent of the adolescents became pregnant and continued sexual activity. Pregnant adolescents reported less overall condom use (P < 0.0001), more infrequent condom use (adjusted odds ratio [AOR] = 4.5, P < 0.001), and more unprotected vaginal sex (AOR = 4.7, P < 0.003). Pregnant adolescents were equally likely to test positive for STDs (31% vs 26%) and to self-report having STDs at the 12-month follow-up period (30% vs 23%)., Conclusions: Findings suggest that pregnant adolescents may be less likely to use condoms than their nonpregnant peers and that STD incidence among pregnant adolescents may be high. Condom use promotion may be important during adolescents' prenatal care., ((C) 2002 Elsevier Science (USA).)

This study of 522 African American female adolescents, ages 14 to 18, investigated associations between condom use and infrequently communicating with sex partners about sexually transmitted diseases (STDs) and pregnancy prevention. Correlates of infrequent communication were identified. Sexually active adolescents were recruited from schools and adolescent medicine clinics in low-income neighborhoods of Birmingham, Alabama. Adolescents completed a self-administered survey and face-to-face interview. Communication frequency was assessed using a five-item scale. Infrequent communication was significantly associated with lower odds of condom use. Multivariate correlates of infrequent communication were less frequent communication with parents about STD/pregnancy prevention, recent sex with a nonsteady partner, low perceived ability to negotiate condom use and fear of this negotiation, and low motivation to use condoms. Given the importance of partner communication in promoting safer sex behaviors, STD and pregnancy prevention programs may benefit adolescents by addressing the identified psychosocial correlates of infrequent communication with their partners.

This study prospectively investigated the hypothesis that ambivalence about becoming pregnant is associated with comparatively less frequent use of contraception. Findings from a sample of sexually active African American adolescent, nonpregnant females (n = 375) supported this hypothesis. Prevention programs may benefit from content designed to redress adolescents' positive beliefs about early parenthood.

Purpose: To identify psychosocial and behavioral correlates of refusing unwanted sex among African-American female adolescents. We hypothesized that greater power in relationships, less concern about negative emotional consequences, supportive family and peers, positive self-perceptions, greater perceived risk, and fewer sexual risk behaviors would be associated with increased odds of refusing unwanted sex., Methods: Data regarding demographics, sexual behaviors, communication with parents, and psychosocial factors relevant to romantic and sexual partnerships were collected both via self-administered questionnaire and structured interview from a clinic- and school-based sample of 522 African-American adolescent females ages 14-18 years in Birmingham, Alabama. Adjusted odds ratios were calculated using logistic regression., Results: Of those who had experienced pressure for unwanted sex (n = 366), 69% consistently refused to engage in unwanted sex. Adolescents with high safer sex self-efficacy and low perceived partner-related barriers (i.e., concerns about partners' negative emotional reactions) to condom negotiation were over 2.5 times more likely to consistently refuse unwanted sex than were those reporting low safer sex self-efficacy and high partner-related barriers. Adolescents who spoke more frequently with their parents about sexual issues were nearly twice as likely to consistently refuse unwanted sex than were those who spoke less frequently with their parents., Conclusions: Sexual-risk reduction efforts directed toward adolescent females should seek to build self-efficacy to negotiate safer sex and provide training in social competency skills that may help to reduce or eliminate partner barriers to condom use. Further, sexual risk-reduction programs may be more effective if they include parents as advocates of safer sexual behaviors.

Objective: To examine associations between parent-adolescent communication about sex-related topics and the sex-related communication and practices of African American adolescent females with partners, as well as their perceived ability to negotiate safer sex., Design: A theory-guided survey and structured interview were administered to 522 sexually active African American females 14 to 18 years old. Recruitment sites were neighborhoods with high rates of unemployment, substance abuse, violence, and sexually transmitted diseases. Multivariate analyses, controlling for observed covariates, were used to identify the association of less frequent parent-adolescent communication with multiple assessed outcomes., Results: Less frequent parent-adolescent communication (scores below the median) was associated with adolescents' non-use of contraceptives in the past 6 months (adjusted odds ratio [AOR] = 1.7) and non-use of contraceptives during the last 5 sexual encounters (AOR = 1.6). Less communication increased the odds of never using condoms in the past month (AOR = 1.6), during the last 5 sexual encounters (AOR = 1.7), and at last intercourse (AOR = 1.7). Less communication was also associated with less communication between adolescents and their sex partners (AOR = 3.3) and lower self-efficacy to negotiate safer sex (AOR = 1.8)., Conclusions: The findings demonstrate the importance of involving parents in human immunodeficiency virus/sexually transmitted disease and pregnancy prevention efforts directed at female adolescents. Pediatricians and other clinicians can play an important role in facilitating parent-adolescent communication about sexual activity.

Objective: This study examines the association between having a history of dating violence and the sexual health of adolescent females., Methods: Black adolescent females (n = 522) completed a survey that assessed dating violence, defined as ever having a physically abusive boyfriend, and an interview that assessed sexual behaviors., Results: Dating violence was reported by 18.4% of adolescents (n = 96). Adolescents with a history of dating violence were, in the past 6 months, 2.8 times more likely to have a sexually transmitted disease, 2.8 times more likely to have nonmonogamous male partners, and half as likely to use condoms consistently. Furthermore, adolescents with a history of dating violence were significantly more likely to fear the perceived consequences of negotiating condom use (odds ratio [OR] = 2.8); fear talking with their partner about pregnancy prevention (OR = 2.6); have a higher perceived risk of acquiring a sexually transmitted disease (OR = 2.1); perceive less control over their sexuality (OR = 2.4); have peer norms nonsupportive of using condoms (OR = 3.1); and have norms nonsupportive of having a healthy relationship (OR = 2.1)., Conclusions: Adolescents who have experienced dating violence are more likely to exhibit a spectrum of unhealthy sexual behaviors, attitudes, beliefs, and norms.

Background: Socioeconomic status is often used to explain race differences in sexually transmitted diseases (STDs), yet the independent association of socioeconomic status and STDs among adolescents has been understudied., Objective: To examine the associations between socioeconomic status and self-reported gonorrhea among black female adolescents, after controlling for sexual risk behaviors., Methods: Interviews and surveys were completed by 522 sexually active black adolescent females residing in low-income urban neighborhoods., Results: Adolescents whose parents were unemployed were more than twice as likely to report a history of gonorrhea, compared with those with employed parents. Adolescents living with two parents were less likely to report a history of gonorrhea., Conclusions: The results of this study indicate that gonorrhea is associated with low socioeconomic status among black adolescent females regardless of the level of sexual risk behaviors. Lower socioeconomic status may be an marker for risky sociosexual environments.

Background: Adolescents' worry (perceived threat) of sexually transmitted diseases (STDs) and HIV infection may have different correlates. This study examined associations between selected psychosocial and behavioral constructs and adolescents' worry about STD and HIV infection., Goal: To assess levels and correlates of worry about STD and HIV among a high-risk sample of black adolescent females., Study Design: High-risk black females (n = 522), enrolled in a randomized, controlled HIV and STD prevention trial, completed a questionnaire and structured interview at baseline. Worry about STD and HIV infection, recent risk behaviors, and several measures potentially related to worry were assessed., Results: Levels of worry for both STD and HIV were low. Recent history of STD infection was associated with STD worry (OR, 4.6) and HIV worry (OR, 2.0). Infrequent communication about sex (OR, 2.0) and low perceived ability to negotiate condom use (OR, 2.0) were related to STD worry; whereas, only partner-specific barriers were related to HIV worry (OR, 1.9)., Conclusions: Despite high risk, adolescents were generally complacent about the threat of infection with STD and HIV. Adolescents' worry about STD and HIV infection had different sets of correlates.