Subsequent Sexually Transmitted Infections Among Adolescent Women With Genital Infection Due to Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis

OBJECTIVE: To identify factors associated with subsequent sexually transmitted infection (STI) (within 1 year of initial infection) due to Chlamydia trachomatis, Neisseria gonorrhoeae or Trichomonas vaginalis. DESIGN: Prospective cohort study. SETTING: A sexually transmitted diseases clinic and four community-based primary care clinics for adolescents. PARTICIPANTS: Female patients (ages 15 to 19 years) with initial diagnosis of chlamydia, gonorrhea, or trichomonas. MAIN OUTCOME MEASURES: Subsequent infection by chlamydia, gonorrhea, or trichomonas. RESULTS: More than 40% of subjects were subsequently infected by at least one STI. Reinfection was common, but infections with sexually transmitted organisms other than the initial infecting organism were also common. Predictors of subsequent infection were black race, gonorrhea as the initial infection, two or more sex partners in the previous 3 months, and inconsistent condom use. CONCLUSIONS: Subsequent STI frequently follow an initial STI, but there is substantial variation in the causal organism. These data suggest the importance of comprehensive STI prevention programs for adolescents rather than organism-specific interventions.