Sex partner concurrency, geographic context, and adolescent sexually transmitted infections

Background: Geographic areas characterized by a high prevalence of sexually transmitted infections (STIs) are critical to the maintenance and persistence of STIs within populations. Sex partner concurrency has been shown to be associated with increased risk for individual-level STIs. Objectives: The objectives of this study were to determine whether gonorrhea rate per census block group and sex partner concurrency independently and interactively are associated with a current bacterial STI among adolescents. Study: Face-to-face interviews and urine testing for Chlamydia trachomatis and Neisseria gonorrhoeae were conducted among female, sexually active, 14- to 19-year-olds presenting for reproductive clinic care between August 2000 and June 2002. Results: Gonorrhea rate per census block group and sex partner concurrency were not independently but were interactively associated with a current bacterial STI. Among participants with a main sex partner who practiced concurrency, living in high-prevalence geographic areas was significantly associated with a current bacterial STI. Conclusions: The results suggest that geographic context may moderate an adolescent sex partner's behaviors. The research adds to the basic understanding of sexually transmitted disease transmission and acquisition in a high-prevalence inner-city setting.