Background: Adolescents and young adults in the United States have high rates of sexually transmitted diseases (STDs) with tremendous adverse consequences on health and health care costs. The proposed project will investigate the relationship of health care utilization, health care behavior, and STD epidemiology using data from Add Health, a national study of 20,000 U.S. adolescents. Waves 1 and 2 of Add health were conducted in 1994-1996 and examined risk behaviors, relationships with peers and parents, interactions with the health care system, and self-reported STDs. In Wave 3 of Add Health, original participants will be re-interviewed and undergo testing for common STDs. Objectives: The proposed study will focus on factors related to interactions with the health care system, specifically acceptance of STD screening, the decision to ascertain STD test results, and follow-through to obtain a complete treatment for three curable STDs: Chlamydia trachomatis (Ct), Neisseria gonorrhea (GC), and, if possible, Trichomonas vaginalis (Tv). We will also develop screening criteria to guide STD testing in non-clinical settings. Finally, we will identify specific health care associated factors that contribute to the excess burden of STDs among certain minority populations. Design and Methods: Wave 3 of Add Health will re-contact, interview, and obtain urine specimens from Wave 1 and 2 participants. Urine specimens will be tested for Ct, GC, and, if possible, Tv. Study participants will be given instructions to obtain the test results by telephone and whether or not participants call for results will be recorded. All participants will positive test results will be re-interviewed 1 month after testing to assess care-seeking behaviors. Analyses: Stratified and repression analyses will be conducted. Screening acceptance, calling for test results, and seeking health care for a positive test will be studied using structural equations modeling with measures of behavioral and normal beliefs, attitudes, expectancies, emotions, and self-efficacy. Logistic regression analysis will be used to develop screening criteria applicable in community settings and to assess specific determinants of race/ethnicity-related differences in prevalence. Significance: This study will identify factors that influence screening acceptance, health care seeking, and health care utilization by young people with or at risk of STDs, thereby creating the basis of more effective interventions to control the continuing epidemic of STDs in young Americans.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Program--Cooperative Agreements (U19)
Project #
Application #
Study Section
Special Emphasis Panel (ZAI1)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of North Carolina Chapel Hill
Chapel Hill
United States
Zip Code
Zhu, Weiyan; Tomberg, Joshua; Knilans, Kayla J et al. (2018) Properly folded and functional PorB from Neisseria gonorrhoeae inhibits dendritic cell stimulation of CD4+ T cell proliferation. J Biol Chem 293:11218-11229
Des Marais, Andrea C; Zhao, Yuqian; Hobbs, Marcia M et al. (2018) Home Self-Collection by Mail to Test for Human Papillomavirus and Sexually Transmitted Infections. Obstet Gynecol 132:1412-1420
Scheidell, Joy D; Beau De Rochars, Valery Madsen; Séraphin, Marie Nancy et al. (2018) Socioeconomic Vulnerability and Sexually Transmitted Infection Among Pregnant Haitian Women. Sex Transm Dis 45:626-631
Knilans, Kayla J; Hackett, Kathleen T; Anderson, James E et al. (2017) Neisseria gonorrhoeae Lytic Transglycosylases LtgA and LtgD Reduce Host Innate Immune Signaling through TLR2 and NOD2. ACS Infect Dis 3:624-633
Gallo, Maria F; Legardy-Williams, Jennifer; Steiner, Markus J et al. (2017) Sexual Relationship Power and Semen Exposure Among Female Patients at a Sexually Transmitted Infection Clinic in Kingston, Jamaica. Arch Sex Behav 46:2157-2164
Woolf-King, Sarah E; Muyindike, Winnie; Hobbs, Marcia M et al. (2017) Vaginal Prostate Specific Antigen (PSA) Is a Useful Biomarker of Semen Exposure Among HIV-Infected Ugandan Women. AIDS Behav 21:2141-2146
Kandler, Justin L; Acevedo, Rosuany Vélez; Dickinson, Mary Kathryne et al. (2016) The genes that encode the gonococcal transferrin binding proteins, TbpB and TbpA, are differentially regulated by MisR under iron-replete and iron-depleted conditions. Mol Microbiol 102:137-51
Kandler, Justin L; Holley, Concerta L; Reimche, Jennifer L et al. (2016) The MisR Response Regulator Is Necessary for Intrinsic Cationic Antimicrobial Peptide and Aminoglycoside Resistance in Neisseria gonorrhoeae. Antimicrob Agents Chemother 60:4690-700
Kissinger, Patricia J; White, Scott; Manhart, Lisa E et al. (2016) Azithromycin Treatment Failure for Chlamydia trachomatis Among Heterosexual Men With Nongonococcal Urethritis. Sex Transm Dis 43:599-602
Scheidell, Joy D; Lejuez, Carl W; Golin, Carol E et al. (2016) Borderline Personality Disorder Symptom Severity and Sexually Transmitted Infection and HIV Risk in African American Incarcerated Men. Sex Transm Dis 43:317-23

Showing the most recent 10 out of 131 publications