Do differences in sexual behaviors account for the racial/ethnic differences in adolescents' self-reported history of a sexually transmitted disease?

Background and Objectives: African-American adolescents have the highest rates of sexually transmitted diseases (STDs) of any racial/ethnic group of adolescents. The objective of this study was to determine the degree to which racial/ethnic differences in sexual behaviors account for African-American adolescents' higher rates of STDs. Study Design: A secondary analysis of data collected as part of the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey was conducted. The sample included 5,189 nationally representative civilian noninstitutionalized sexually experienced United States adolescents 14 to 21 years of age. Results: The age-and sex-adjusted odds ratio (OR) for a reported history of an STD for African-American adolescents was 3.86 (95% confidence interval [CI] = 1.57,9.50). The STD risk for African-American youth increased with the adjustment for other sociodemographic factors (OR = 4.13; CI = 1.71,9.99) and decreased with the adjustment for sexual behaviors (OR = 3.67; CI = 1.55, 8.66). Conclusions: Differences in sexual behaviors do not fully account for African-American adolescents' increased risk for STDs. Interventions designed to reduce sexual risk taking among African-American adolescents may not ameliorate racial/ethnic differences in rates of STDs.