Racial/Ethnic differences in adolescents' self-report of a sexually transmitted disease

African-American youths have among the highest rates of sexually transmitted diseases (STDs) of any racial/ethnic group of adolescents. Previously reported difference in sexual behaviors do not appear to be of sufficient magnitude to account for their increased risk for STDs, The objective of this study was to determine to what degree sexual behavioral differences account for racial/ethnic differences in STDs, In this study, we performed a secondary analysis of national data collected as part of the Youth Risk Behavior Survey (YRBS) supplement to the 1992 National Health Interview Survey (NHIS). We used the SUDAAN statistical package and weighted data to compute frequencies and odds ratios. The sample consisted of 5189 sexually active adolescents; 48.5% male. Mean age was 18.5 years (range=14-21 years). Thirty-seven percent were out-of-school. The racial/ethnic distribution was 60.2% white, 18.8% black, 16.7% Hispanic, and 4.4% other. Overall, 7.0% of adolescents reported a history of an STD. Black adolescents were at increased risk for reporting a history of an STD compared to other adolescents: 13.1% of black adolescents had a history of an STD compared to 5.9% of white adolescents, 4.5% of Hispanic adolescents, and 4.6% of other adolescents (p<0.001). Black adolescents remained at high risk for a history of an STD (Odds Ratio= 3.67; 95% Confidence Interval=1.55-8.66) after adjusting for sociodemographics (age, gender, highest educational attainment of responsible adult, family income, and region of the country) and sexual behaviors (age of first sex, number of lifetime sexual partners, number of sexual partners in the last three months, use of alcohol or drugs during last sex, and use of condom last sex). These data suggest that racial/ethnic variations in rates of self-reported STDs may be related, in part, to racial/ethnic differences in the risk of being exposed to an infected partner rather than self-reported differences in sexual behaviors.