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Published online November 23, 2009
PEDIATRICS (doi:10.1542/peds.2009-0674)
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Articles

Prevalence of Sexually Transmitted Infections Among Female Adolescents Aged 14 to 19 in the United States

Sara E. Forhan, MD, MPHa,b, Sami L. Gottlieb, MD, MSPHb, Maya R. Sternberg, PhDb, Fujie Xu, MD, PhDb, S. Deblina Datta, MDb, Geraldine M. McQuillan, PhDc, Stuart M. Berman, MD, ScMb, Lauri E. Markowitz, MDb

aEpidemic Intelligence Service, Office of Workforce and Career Development, and
bDivision of STD Prevention, National Center for HIV, Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; and
cNational Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland

Objective Most young women initiate sexual activity during adolescence; risk for sexually transmitted infections (STIs) accompanies this initiation. In this study we estimated the prevalence of the most common STIs among a representative sample of female adolescents in the United States.

Methods Data were analyzed from 838 females who were aged 14 to 19 and participating in the nationally representative National Health and Nutrition Examination Survey 2003–2004. After interview and examination, survey participants provided biological specimens for laboratory testing. The main outcome was weighted prevalence of at least 1 of 5 STIs: Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus type 2, and human papillomavirus (HPV) (any of 23 high-risk types or type 6 or 11).

Results Prevalence of any of the 5 STIs was 24.1% among all and 37.7% among sexually experienced female adolescents. HPV (23 high-risk types or type 6 or 11) was the most common STI among all female adolescents (prevalence: 18.3%), followed by C trachomatis infection (prevalence: 3.9%). Prevalence of any of the STIs was 25.6% among those whose age was the same or 1 year greater than their age at sexual initiation and 19.7% among those who reported only 1 lifetime sex partner.

Conclusions The prevalence of STIs among female adolescents is substantial, and STIs begin to be acquired soon after sexual initiation and with few sex partners. These findings support early and comprehensive sex education, routine HPV vaccination at the age of 11 to 12 years, and C trachomatis screening of sexually active female adolescents.

Key Words: sexually transmitted diseases • adolescent • prevalence

Abbreviations: aOR, adjusted OR

Accepted Jul 9, 2008.


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