Sex Transm Infect

Objectives

Within the context of rising rates of reportable sexually transmitted infections (STIs) in the United States (US), we used national survey data to examine temporal trends in high risk factors that indicate need for STI/HIV preventive services among key subpopulations with disproportionate STI rates.

Methods

We used data from the 2002 (n=12,571), 2006-10 (n=22,682) and 2011-15 (n=20,621) National Survey of Family Growth (NSFG). NSFG is a national probability survey of 15-44 year olds living in US households. We examined STI risk factors among sexually active men who have sex with men (MSM) and Hispanic, non-Hispanic black, 15-19 year old, 20-24 year old, and 25-29 year old women who have sex with men (WSM) and men who have sex with women (MSW). Risk behaviours included: received money or drugs for sex, gave money or drugs for sex, partner who injected drugs, partner who has HIV, nonmonogamous partner (WSM, MSW only), and male partner who had sex with other men (WSM only). Endorsement of any of these behaviours was recoded into a composite variable focusing on factors indicating increased STI risk (yes/no). We used chi-squares and logistic regression (calculating predicted marginals to estimate adjusted prevalence ratios) to examine STI risk factors over time among the key subpopulations.

Results

From 2002 to 2011-2015, reported STI risk factors did not change or declined over time among key subpopulations in the US. In adjusted analyses comparing 2002 to 2011-2015, we identified significant declines among WSM: Hispanics (aPR=0.84(0.68-1.04), non-Hispanic blacks (aPR=0.69(0.58-0.82), adolescents (aPR=0.71(0.55-0.91), and 25-29 year olds (aPR=0.76(0.58-0.98); among MSW: Hispanics (aPR=0.53(0.40-0.70), non-Hispanic blacks (aPR=0.74(0.59-0.94), and adolescents (aPR=0.63(0.49-0.82); and among MSM (aPR=0.53(0.34-0.84).

Conclusions

While reported STIs have increased, STI risk factors among key subpopulations were stable or declined. Condom use related to these risk factors, sexual mixing patterns, and STI testing should be examined.

31350378

PMC6982539

Journal Article

CC999999/ImCDC/Intramural CDC HHS/United States

CDC Public Access