Laboratory-Diagnosed Sexually Transmitted Infections in Former Foster Youth Compared With Peers

Kym Renee Ahrens · Laura Paul Richardson · Mark E. Courtney · Carolyn A. McCarty · Jane M. Simoni · Wayne J. Katon

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Child Welfare and Adoption Adolescent Sexual and Reproductive Health Reproductive tract infections research

Abstract

OBJECTIVES: The objective of this study was to evaluate the association between having resided in foster care and risk for sexually transmitted infection (STI) during young adulthood. METHODS: Multiple regression analyses were performed by using Waves I to III of the National Longitudinal Study of Adolescent Health (1994-2002) to evaluate the association between foster care status and STI biomarkers and risk behaviors. Female (N = 7563) and male participants (N = 6759) were evaluated separately. Covariates in all models included baseline age, race, ethnicity, parental education level, parental income level, and average neighborhood household income level. RESULTS: Female participants who had been in foster care were more likely to have Trichomonas (odds ratio [OR]: 3.23 [95% confidence interval (CI): 1.45-7.23) but not gonorrhea or chlamydia and reported increased sexual risk behaviors compared with nonfostered peers. Male participants who had been in foster care were more likely to have both gonorrhea (OR: 14.28 [95% CI: 2.07-98.28]) and chlamydia (OR: 3.07 [95% CI: 1.36-6.96]) but not Trichomonas and did not report a higher risk for most sexual risk behaviors than nonfostered peers. CONCLUSIONS: Results suggest that individuals who have been in foster care are at increased risk for STIs during young adulthood. The pattern of exposure may differ between male and female individuals. If findings are confirmed, they suggest that health care providers who work with these youth should adjust their STI screening practices. Child welfare agencies should also consider targeted interventions to reduce STI risk in this population.

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References

2007Adverse childhood experiences and mental health in young adults: a longitudinal survey 2006Child Maltreatment in the United States: Prevalence, Risk Factors, and Adolescent Health Consequences 2005Midwest Evaluation of the Adult Functioning of Former Foster Youth: outcomes at age 19 2007Midwest Evaluation of the Adult Functioning of Former Foster Youth: Outcomes at Ages 23 and 24 2008The impact of cumulative childhood adversity on young adult mental health: Measures, models, and interpretations 1994Assessing the Health Status of Children Entering Foster Care 1997Foster care's youngest: A preliminary report.

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2015Physical Health Problems and Barriers to Optimal Health Care Among Children in Foster Care 2010Child Maltreatment and the Transition to Adult-Based Medical and Mental Health Care 2013The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services 2019Providing sex and relationships education for looked-after children: a qualitative exploration of how personal and institutional factors promote or limit the experience of role ambiguity, conflict and overload among caregivers 2016

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