Multiple sexual partners and partner choice are believed to increase the risk of sexually transmitted disease (STD), but these behaviors had not previously been assessed outside of clinical populations. In this study, a cross-sectional survey among single, white, female students in their senior year of college was conducted to measure the association between behavioral risk factors and the acquisition of self-reported STDs during college. The usable response rate was 47.2% (n = 467). The combined prevalence of chlamydial infection, gonorrhea, genital herpes, human papillomavirus (HPV) infection, syphilis, and trichomoniasis during a 3.5-year period was 11.7%. There was a strong association between number of sexual partners and having an STD: those women with 5 or more sexual partners were 8 times more likely to report having an STD than those with only 1 partner, even after adjusting for age at first intercourse (odds ratio = 8.1; 95% confidence interval = 1.99, 32.64). The prevalence of a history of STDs increased with more causal partner choice and earlier age at first intercourse, but neither factor was independently associated with a history of STDs. Of the respondents, 23% always used condoms. Future research should focus on identifying ways of effectively changing high-risk sexual behavior.
PIP: In 1990, researchers analyzed data on 467 19-22 year old white female seniors at the University of Michigan to examine partner choice and other behavioral risk factors in relation to sexually transmitted diseases (STDs). 369 (79%) had had sexual intercourse. 43 (11.7%) had at least 1 STD while at the university. The most frequently reported STDs were chlamydia infection (6.3%) and genital warts (5.2%). Other STDs made up 2% of women with at least 1 STD: trichomoniasis, human papillomavirus infection, genital herpes, gonorrhea, and syphilis. Mean age at 1st intercourse stood at 17.7 years. Number of sexual partners while attending university ranged from 1 to 107 (mean 4.4). 70% had 1 partner and 33% =or5 partners. 44% had sex only within a steady relationship. 34% had sex with at least 1 casual partner and 23% with at least 1 nonsteady partner but no casual partners. 77% used condoms at least sometimes. Just 23% always used them. Students who had had an abnormal PAP smear were 8.36 times more likely to have had an STD than those without an abnormal PAP smear. The prevalence of STDs increased significantly with number of sexual partners (p.001). This was also true for chlamydia and genital warts (p.001). Prevalence of these 2 STDs rose as did the number of nonsteady and casual partners (p=.003 and p=.007, respectively). The odds ratio (OR) for women with at least 5 partners was 8.07. STD prevalence rose as the age at 1st intercourse fell (OR=2.19 for =or15 years; p=.035). The trend was similar for chlamydia (p=.002), but not so for genital warts. Even though the percentage of students who had had an STD was greatest among those with at least 1 casual partner (21.5% vs. 3.2% for only steady partners), the association was not significant. Women who always used condoms had the lowest STD prevalence (7.1%), but those who never used condoms had STDs (10.9%) less often than those who did some of the time (15.8%) or most of the time (12.3%). More research is needed to determine means to effectively change high risk sexual behavior.