Adolescents' sexually transmitted disease protective attitudes predict sexually transmitted disease acquisition in early adulthood

Background Estimates suggest that about 48% of nearly 19 million cases of sexually transmitted diseases (STDs) occurring annually in the United States are acquired by persons aged 15-24 years. The purpose of this study was to test the hypothesis that adolescents' attitudes about protecting themselves from STDs predict their laboratory-confirmed prevalence of STDs in early adulthood. Methods Wave 3 of the National Longitudinal Study of Adolescent Health assessed Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. This wave 3 data were regressed on data collected in wave 1 (when those followed were teens). A single-item measure (with a 5-point response option) assessed adolescents' attitude: "It would be a big hassle to do the things necessary to completely protect yourself from getting an STD." Results Valid urine specimens were provided by 8297 adolescents who also completed the self-reported measures needed for this study. Overall, 6.4% of the weighted sample tested positive for at least 1 of the 3 STDs. Controlling for age, gender, minority status, and age of sexual debut (all of which are well-established predictors of STD prevalence), attitude toward STD protection achieved significance (P <.001). Each additional point on the 5-point scale increased adolescents' odds of testing positive for an STD in early adulthood by about 13%. Of interest, the attitudinal measure did not interact with any of the other variables. Conclusions Findings provide evidence suggesting that safer sex programs may benefit adolescents by fostering positive attitudes toward practices that avert STD acquisition.