Rollins School of Public Health, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia 30322, USA.
Pediatrics. 2011 Feb;127(2):208-13. doi: 10.1542/peds.2009-0892. Epub 2011 Jan 3.
Self-reported behavior has been the cornerstone of sexual health research and clinical practice, yet advances in sexually transmitted disease (STD) screening provide researchers with the opportunity to objectively quantify sexual risk behaviors. However, the extent to which young adults' laboratory-confirmed STD results and self-reported sexual behaviors are consistent has not been assessed in a nationally representative sample.
Data are derived from participants who completed wave 3 in the National Longitudinal Study of Adolescent Health. Young adults (N = 14 012) completed an audio computer-assisted self-interviewing survey and provided a urine specimen to detect the presence of Chlamydia trachomatis and Neisseria gonorrhoeae, and a polymerase chain reaction assay to detect Trichomonas vaginalis.
More than 10% of young adults with a laboratory-confirmed positive STD result reported abstaining from sexual intercourse in the 12 months before assessment and STD testing. After controlling for several sociodemographic factors, self-reported sex (versus those who reported abstinence) in the previous 12 months was significantly associated with testing positive, but the odds of testing positive were only slightly more than twofold (adjusted odds ratio: 2.11 [95% confidence interval: 2.097-2.122]).
Findings indicate discrepancy between young adults' positive STD status and self-reported sexual behavior. No significant correlates of discrepant reporting were identified. From a clinical standpoint, the discrepancies between STD positivity and self-reported sexual behavior observed in this nationally representative sample suggest that routine STD screening may be beneficial and necessary to reduce STD morbidity among young adults.
自我报告的行为一直是性健康研究和临床实践的基石，但性传播疾病（STD）筛查的进展为研究人员提供了机会，可以客观地量化性行为风险。然而，在全国代表性样本中，尚未评估年轻人的实验室确诊 STD 结果和自我报告性行为的一致性程度。
数据来自完成青少年健康纵向研究第 3 波的参与者。年轻人（N=14012）完成了音频计算机辅助自我访谈调查，并提供了尿液样本，以检测沙眼衣原体和淋病奈瑟菌的存在，并进行聚合酶链反应检测阴道毛滴虫。
超过 10%的实验室确诊阳性 STD 结果的年轻人报告在评估和 STD 检测前的 12 个月内禁欲。在控制了几个社会人口统计学因素后，在过去 12 个月内自我报告的性行为（与报告禁欲的人相比）与检测呈阳性显著相关，但检测呈阳性的几率仅略高于两倍（调整后的优势比：2.11[95%置信区间：2.097-2.122]）。
研究结果表明，年轻人的阳性 STD 状况和自我报告的性行为之间存在差异。未确定不一致报告的显著相关因素。从临床角度来看，在这个具有全国代表性的样本中观察到的 STD 阳性和自我报告性行为之间的差异表明，常规 STD 筛查可能对减少年轻人的 STD 发病率有益且必要。
