A daily diary analysis of vaginal bleeding and coitus among adolescent women
Abstract
Objective To evaluate the effect of vaginal bleeding on the likelihood of coitus among adolescent women. Methods Participants were 191 sexually active women aged 14 to 21 years enrolled from a sexually transmitted disease clinic and three primary care adolescent clinics. Data were collected from diaries maintained for up to 7 months. Subjects recorded each occurrence of coitus, partner initials, condom use, and vaginal bleeding. Multivariable logistic regression was used for the analyses. Generalized estimating equations approach was used to adjust the estimated parameters for within-subject correlation. Results Subjects reported a total 21,334 diary days, with 2684 days with coitus (12.6% of diary days) and 1433 days with bleeding (6.7% of diary days). Only 65/2684 (2.4%) coital events were associated with vaginal bleeding. Multivariable analysis showed that absence of bleeding was associated with increased likelihood (odds ratio = 4.2) of coitus, independent of age, race, and usual coital frequency. Younger age and higher coital frequency were associated with increased likelihood of any coitus during vaginal bleeding. Conclusions For most sexually active adolescent women, bleeding is associated with avoidance of coitus.