Abstract

High risk sexually transmitted disease (STD)/human immunodeficiency virus (HfV) transmission behaviour appears to be the norm, not the exception, for most adolescents. The perception of STD/HIV risk and actual risk do not always match. The major motivating factor for condom use evident in adolescents was fear of pregnancy, not fear of the acquired immune deficiency syndrome or STDs. Other factors influencing decreased condom use included: embarrassment about buying condoms: difficulty discussing condoms with a prospective partner; use of oral contraceptives; belief that condoms interfere with sexual pleasure; low HIV knowledge; and, for women, a large number of sexual partners. Overall. females reported having had more STDs than males. Prostitutes, both male and female, reported the highest rates (45% and 68%, respectively). Of the street youths studied, 16% reported having at least one prior STD diagnosis, compared to 9% of school dropouts and 5% of first year college students. The number of sexual partners and participation in anal intercourse strongly inlluenced the reported STD rate for street youths. STD/HIV risk reduction educational programs must be targeted and adapted to the cultural and social needs and resources of the different adolescent groups, particularly street youth, who are clearly a 'core' group for adolescent STD.