Despite current and ongoing prevention efforts, rates of sexually transmitted infections (STIs), including gonorrhea among young people remains high. The majority of the prevention efforts have focused primarily on vaginal intercourse, even though a substantial number of young people are engaging in non-coital activity including oral sex. Although the risk of transmission of STIs is reduced when comparing oral sex to vaginal or anal sex, various studies suggest that oral sex is still a potential transmission route for a number of STIs, including gonorrhea. Because the prevalence of oral sex among young people is relatively high and condom use with this behavior is low the contribution of oral sex to gonorrhea transmission and maintenance of infection among this population may be more important than expected despite the lower transmissibility with oral sex. Testing for pharyngeal gonorrhea among young people is particularly relevant given that the majority of infections are asymptomatic and treatment for pharyngeal infections maybe different from treatments used for urogenital infections. Furthermore, limited data on factors that place young people at increased risk for pharyngeal infections make it unclear what STI prevention interventions should include and how risk reduction messages should be framed. The proposed study will investigate risk factors associated with pharyngeal gonorrhea among young people (i.e., ages 15 - 24) attending public sexually transmitted disease (STD) clinics and identify behaviors that place young people at increased risk for pharyngeal gonorrhea. The formative research will be used to adapt and pilot test an evidence-based STI prevention intervention (Project SAFE) in order to reduce risky behaviors that place young people at increased risk for STIs, including pharyngeal gonorrhea. The study described in this award application is the first example of research designed to broaden the applicability of an already proven, evidence-based intervention for STI prevention by inclusion of messages surrounding oral sex. This award application is intended to support the applicant's Mentored Research Scientist Development Award (K01) through mentoring, formal training in health related behavior change, behavioral prevention methods, and interventions to reduce STI transmission. The long-term goals of this research project are to provide the foundation for STI prevention research. At the end of the award period, the applicant will submit a R01 or R34 proposal to evaluate the new intervention in an appropriately powered randomized trial. This will be the center the applicant's research agenda for the next decade - to become an independent investigator conducting prevention interventions that reduce STIs among populations at high risk, namely young people.

Public Health Relevance

Gonorrhea is the second most common reported disease in the United States, with the highest reported rates among those 15 - 24 years of age. Although there has been a considerable amount of effort aimed at prevention and intervention efforts to reduce risky sexual behaviors among adolescents and young adults, rates of sexually transmitted infections, including gonorrhea remain high among this group. Behavioral prevention strategies, grounded in theory and adapted based on culturally, contextually, and epidemiologically relevant research could have an impact on rates of gonorrhea infection among young people.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AI091861-05
Application #
8839178
Study Section
Microbiology and Infectious Diseases B Subcommittee (MID)
Program Officer
David, Hagit S
Project Start
2011-05-05
Project End
2016-04-30
Budget Start
2015-05-01
Budget End
2016-04-30
Support Year
5
Fiscal Year
2015
Total Cost
$119,176
Indirect Cost
$8,828
Name
University of California Los Angeles
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Baker, Zoƫ; Javanbakht, Marjan; Mierzwa, Stan et al. (2018) Predictors of Over-Reporting HIV Pre-exposure Prophylaxis (PrEP) Adherence Among Young Men Who Have Sex With Men (YMSM) in Self-Reported Versus Biomarker Data. AIDS Behav 22:1174-1183
Shover, Chelsea L; Beymer, Matthew R; Unger, Erin M et al. (2018) Accuracy of Presumptive Gonorrhea Treatment for Gay, Bisexual, and Other Men Who Have Sex with Men: Results from a Large Sexual Health Clinic in Los Angeles, California. LGBT Health 5:139-144
van den Berg, Jacob J; Javanbakht, Marjan; Gorbach, Pamina M et al. (2018) Partner Notification for Youth Living With HIV in 14 Cities in the United States. J Acquir Immune Defic Syndr 77:46-52
Javanbakht, Marjan; Westmoreland, Drew; Gorbach, Pamina (2018) Factors Associated With Pharyngeal Gonorrhea in Young People: Implications for Prevention. Sex Transm Dis 45:588-593
Javanbakht, Marjan; Boudov, Melina; Anderson, Laura J et al. (2014) Sexually transmitted infections among incarcerated women: findings from a decade of screening in a Los Angeles County Jail, 2002-2012. Am J Public Health 104:e103-9
Javanbakht, Marjan; Stirland, Ali; Stahlman, Shauna et al. (2013) Prevalence and factors associated with Trichomonas vaginalis infection among high-risk women in Los Angeles. Sex Transm Dis 40:804-7
Javanbakht, Marjan; Gorbach, Pamina; Stirland, Ali et al. (2012) Prevalence and correlates of rectal Chlamydia and gonorrhea among female clients at sexually transmitted disease clinics. Sex Transm Dis 39:917-22