School, Neighborhood, Family, and Individual Determinants of Self-Reported STD Among Adolescents: Findings from the National Longitudinal Study of Adolescent Health
PWP-CCPR-2004-040
Abstract
Context: Adolescents have among the highest rates of STD, but until recently it has been difficult to characterize the multiple social and behavioral factors that affect STD risk because of measurement and methodological issues.
Methods: Data from Wave I of the National Longitudinal Study of Adolescent Health (Add Health) are used to estimate effects of school, neighborhood, family, and individual characteristics on acquiring an STD. For sexually active teens, we also estimate the extent to which age at first intercourse affects STD acquisition. Additionally, we investigate the determinants of STD occurrence between Waves I and II of Add Health, and model the effects of prior STD acquisition. Random intercept logistic regression and random intercept piecewise exponential hazard regression are used to account for possible clustering in the Add Health data.
Results: Overall, 7.0 percent of sexually active teens reported ever having an STD as of Wave I, and 6.7 percent reported having an STD between Waves I and II. Among all Wave I teens—uninitiated as well as sexually active—age, gender, race/ethnicity, family
background characteristics, neighborhood and school characteristics affect STD acquisition. Among sexually active Wave I teens, those with a younger age at first intercourse are at greater risk of experiencing an STD. Other factors contribute, but to a lesser degree. For example, family structure becomes nonpredictive. For acquisition of an STD between Waves I and II, females, blacks, teens with lower levels of mother’s education, and those who had an STD previously are at higher risk. Determinants of STD
Conclusions: The findings support our hypothesis that multiple social and behavioral factors influence lifetime history of STD. Also, age at first intercourse and STD history are valid indicators of risk-related behavior.
