Abstract
PURPOSE: Young women of color in the United States are disproportionately affected by sexually transmitted infections (STIs). We characterize the protective behaviors used by young women to reduce their vulnerability to STI acquisition and examine how STI prevention strategies differ by race/ethnicity. METHODS: From 2015 to 2016, women aged 13-24 years presenting to five Northern California family planning clinics were surveyed about their STI prevention strategies. The chi-squared tests and multivariable logistic regression identified associations between race/ethnicity and use of sexual health-promoting strategies. RESULTS: Among 790 women, the most common strategies included condom use (67%), asking partners about STIs (47%), limiting sexual partners (35%), frequent STI screening (35%), and asking partners about other sexual partners (33%). Black, Hispanic, and Asian women had decreased odds of utilizing strategies before intercourse compared with white women (adjusted odds ratio [aOR](black): .25, confidence interval [.14-.47]; aOR(Hispanic): .36, CI [.20-.65]; aOR(Asian): .44, CI [.23-.84]). Black women had decreased odds of using strategies requiring partner involvement (aOR(black): .35, CI [.13-.92]). White women were more likely to report that providers discussed condoms (aOR: 2.53, CI [1.04-6.15]) and talked to partners about STIs (aOR: 2.56, CI [1.52-4.32]) compared with nonwhite women. Black and Hispanic women were more likely to feel very uncomfortable discussing lifetime sexual partners (aOR(black): 4.26, CI [1.36-13.30] and aOR(Hispanic): 5.35, CI [1.79-15.99]) and condom use (aOR(black): 3.05, CI [1.14-8.15] and aOR(Hispanic): 2.86, CI [1.11-7.35]) with providers. CONCLUSIONS: Young women use diverse strategies to prevent STIs that vary by race/ethnicity. Providers can use these findings to improve sexual health counseling and promote equitable education and services.