799 - A Socio-Ecological Approach to Examining Predictors of Sexually Transmitted Infection Diagnoses among a Nationally Representative Sample of Adolescents

Publication Number: 799.4000

Chioma N. Kas-Osoka, Meharry Medical College, Nashville, TN, United States; Derek Wilus, Meharry Medical College, Nashville, TN, United States; Mohammad Tabatabai, Meharry Medical College, Nashville, TN, United States; Velma McBride. Murry, Vanderbilt University School of Medicine, Nashville, TN, United States

Background: Even though adolescents (15-24 years) represent 25% of the sexually active population, they account for nearly half (49.8%) of all new sexually transmitted infection (STI) diagnoses. To address this public health issue, understanding the factors that impact sexual health risk among this population is imperative. The socio-ecological model (SEM) provides a lens with which to do so. The framework posits that health behaviors and outcomes result from behavioral and environmental factors.

Objective: This study aims to use SEM to guide the analysis of demographic, behavioral, and systemic predictors of sexually transmitted infection (STI) diagnoses among a nationally representative sample of adolescents.

Design/Methods: We examined the National Survey on Drug Use and Health (NSDUH) (2016-2019); a nationally representative sample that evaluates tobacco, alcohol, substance use, and other health behaviors among non-institutionalized individuals 12 years of age and older. Using SPSS, we conducted a multivariate logistic regression to identify the demographic, behavioral, and systemic level factors that impacted STI diagnoses among adolescents aged 12-17 years.

Results: From 2016-2019, among a sample of 53,217 adolescents, 491 self-reported an STI diagnoses in the past year. The mean age of participants was 14.55 years (±1.68). Overall trends indicated that marijuana use and alcohol consumption remained relatively consistent over time. Those who reported having an STI, also reported to highest rates of marijuana use (46%) and alcohol consumption (53%). Results also indicated that several factors predicted STI diagnoses including being female (p < 0.001, AOR=1.650), Black (p < 0.001, AOR=1.623), using marijuana (p < 0.001, AOR=2.566), alcohol consumption (p=0.008, AOR=1.370), and being on probation (p < 0.001, AOR=2.541). Additionally, for each year of age increase, the odds of STI diagnoses increased by 16% and youth residing in a small metro area had a decreased risk of an STI diagnoses compared to those in a large metro area (p=0.0004, AOR=.730). Among these variables, the strongest predictors of STI diagnoses were marijuana use and being on probation.

Conclusion(s): Structuring our analysis using SEM allowed us to identify an STI risk profile for adolescents that encompassed demographic, behavioral and systemic variables. Addressing the factors that impact STI diagnoses among adolescents must be a medical and overall public health priority. Interventions designed to reduce STI risk should target justice-involved adolescents and include strategies to discuss the impact of substance use on STI acquisition.