The protective value of school enrolment against sexually transmitted disease: A study of high-risk African American adolescent females

Objective: To identify whether school enrolment is protective against laboratory-confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors. Methods: A cross-sectional study of 715 African-American adolescent females (15-21 years old) was conducted. Data collection included an audio-computer-assisted self-interview lasting about 60 min and a self-collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. Results: In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance. Conclusion: This study provides initial evidence suggesting that keeping high-risk African-American adolescent females in school (including forms of school that occur after high-school graduation) may be important from a public health standpoint.