The Context of HIV Risk Among Drug Users and Their Sexual Partners

15-to 19-year-old teenage females during the same time period
(CDC 1991a). Racial and gender differences among adolescents also are
apparent in trends of gonorrhea; while rates among white males and
females have steadily declined over the last decade, rates among African-
American males and females have increased during this time period
(Cates 1990). Currently, 15- to 19-year-old females have the highest
rates of gonorrhea among all females, and 15 to 19-year old males have
the second highest rates among all males (CDC 1991a). Moreover,
recent data indicate that in 1990, rates of primary and secondary syphilis
increased among adolescent males and females ages 15 to 19
(CDC 1991a).
Chlamydia trachomatis, which causes nongonococcal urethritis in males
and mucopurulent cervicitis in females, is estimated to be the most
prevalent bacterial STD in the United States (Schydlower and Shafer
1990); it is most commonly associated with pelvic inflammatory disease
(PID) in sexually experienced adolescent females (Coupey and Klerman
1992; Schydlower and Shafer 1990). In adolescent males, the prevalence
rates of asymptomatic chlamydia range from 8 percent to 35 percent in
various populations. Although complications of chlamydial infections in
males are unusual, a major risk of transmission to female sexual partners
is of tremendous concern. It is estimated that 30 to 60 percent of
adolescent females have asymptomatic chlamydial infections, and 10 to
30 percent of cervical chlamydial infections infect the fallopian tubes
(Schydlower and Shafer 1990). Chlamydia is frequently asymptomatic
and goes undiagnosed and untreated unless routine clinical screening
occurs.
The human papillomavirus (HPV) causes genital warts and is associated
with cervical cancer many years after the first infection. Prevalence rates
of up to 38 percent have been documented in adolescent females,
depending on the population and the method used to detect the infection
(Moscicki 1990; Rosenfeld et al. 1989).
In essence, the prevalence data reported from various studies indicate that
inner-city, racial or ethnic minority adolescents have higher rates of STDs
when compared to their white counterparts (Boyer 1990; Cates 1990). In
addition, socioeconomic factors are associated with STDs in adolescents.
This finding comes from data that is reported from urban juvenile
detention centers where poor, inner-city minority teens are
overrepresented (Boyer 1990; Cates 1990).
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