A method for identifying persons at high risk for sexually transmitted infections: opportunity for targeting intervention

Am J Public Health. 1993 Apr;83(4):520-4. doi: 10.2105/ajph.83.4.520.


Objectives: The purpose of this study was to develop a method to identify persons at high risk for acquiring new sexually transmitted infections.

Methods: Computerized medical records from sexually transmitted disease clinics in Dade County, Florida, were used to conduct a retrospective cohort study. For all patients who visited in 1987, risk factors were identified for returning to the clinics within a year with a new sexually transmitted infection. Predictor variables were derived from the index visit and any visits in the year prior to the index visit. Logistic regression was used to develop a model that was applied to all patients who attended in 1989.

Results: Of 24,439 patients attending in 1987, 18.5% returned within a year with a new infection. Return rates were highest for 15- to 19-year-old Black males (31.8%). The highest odds ratios for returning were a diagnosis or treatment for an infection in the previous year and a diagnosis or treatment for infection at the index visit. The patients predicted to be at highest risk had a 39% return rate. There were as many new infections among the 2893 patients at highest risk as there were among the 13,326 patients at lowest risk.

Conclusions: We developed a model that identifies persons at very high risk for sexually transmitted infection. These persons should be targeted for intensive intervention to reduce their risk.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Ambulatory Care Facilities
  • Cohort Studies
  • Female
  • Florida / epidemiology
  • Forecasting
  • Health Status Indicators*
  • Humans
  • Incidence
  • Logistic Models*
  • Male
  • Mass Screening / standards
  • Medical Records Systems, Computerized
  • Odds Ratio
  • Predictive Value of Tests
  • Racial Groups
  • Recurrence
  • Residence Characteristics
  • Retrospective Studies
  • Seasons
  • Sex Factors
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / etiology
  • Sexually Transmitted Diseases / prevention & control