Sexual abuse, sex before age 16, and high-risk behaviors of young females with sexually transmitted diseases.

OBJECTIVE To compare rates of sexually transmitted diseases (STDs) in young women who were sexually abused, sexually precocious, and engaged in high-risk behaviors with the rates of STDs in young women who had none of these experiences. DESIGN In this descriptive, comparative study, purposive, nonrandom sampling was used to obtain representation of women in four ethnic groups. Women completed a questionnaire on their sexual history and high-risk behaviors, sexual abuse and age of occurrence, and health issues, including STDs. Chi-square analyses were used to explore differences in these risk factors for STDs. SETTING Data were collected at 44 urban and rural sites, including health clinics, private care providers, academic institutions, and Indian reservations. PARTICIPANTS A convenience sample of 1,994 women ages 18-22 years and representing four ethnic groups. RESULTS Sexually abused, precocious women who also engaged in high-risk sexual behaviors were the most likely to have had an STD: The sequence of these events was not significant. High-risk sexual behaviors appeared to be a greater risk factor for STDs than sexual abuse or precocity. CONCLUSIONS Young women who engage in high-risk sexual behaviors, such as sex on a first date or with a stranger, are at great risk for acquiring STDs. Nurses must be advocates for sex education in high schools to inform teenagers about the dangers of high-risk behaviors and STDs, and to explain ways to handle sexual coercion and possible rape.