All ETDs from UAB

Advisory Committee Chair

Susan Davies

Advisory Committee Members

John Bolland

Retta Evans

Diane Grimley

Cathy Simpson

Tina Simpson

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


In the United States, adolescent women between the ages of 14 and 19 are estimated to bear the largest burden of sexually transmitted infections. Left untreated, these infections have the potential to result in several adverse reproductive health outcomes. Sexually risky behaviors, including early sexual initiation, sexual partner concurrency, and the use of vaginal douche products increase the risk for the contraction of sexually transmitted infections. Further, having a sexual relationship with a male partner who is known to have other partners or a history of contact with the justice system might put a woman at additional risk. Utilizing a subset of data from a larger study related to the use of vaginal douche products, the purpose of the present study is three fold: (a) to assess the predictors of the use of douche products among a convenience sample of adolescent and young adult women; (b) to assess the prevalence and predictors of engaging in sexual partner concurrency; and (c) to assess the likelihood of ever having a sexually transmitted infection with regard to main sex partner history of contact with the justice system. Among the sample, 46% of participants were regular users of vaginal douche products. The largest predictor of use was the use of other feminine hygiene products (OR = 38.48, p<0.000), followed by the recommendation from a person of influence that she should use douche products (OR =8.06, p<0.000). Thirty-six percent of the population was engaging in sexual partner concurrency, the largest predictor of which was the perception that the main male sex partner was also sexually concurrent (OR= 4.43, p<0.000). Having a main partner with a history of justice system contact was associated with a history of sexually transmitted infection. Women in the sample whose partners had justice system contact were more likely to be engaging in sexual concurrency (OR=3.01, p<0.000), and to ever have had a sexually transmitted infection than women whose partners did not have justice system contact (OR=2.33, p<0.008). Ultimately the women who are a part of this sample are not impacted by each of these risk factors in isolation. It becomes increasingly important to change the social norms with regard to the acceptability of behaviors which put this population at increased risk for adverse reproductive health outcomes.

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