To the Editor.
—The letter by Fleisher et al1 raises significant questions regarding the reliability of identifying women at risk for acquiring human immunodeficiency virus (HIV) infection by assessing prior history of sexually transmitted disease (STD). Their work clearly shows how women at high risk for STD do not know what infections constitute STD and may incorrectly answer the global question: "Have you ever had an STD?"As physicians treating adolescents who are also high risk for acquiring STD and HIV, it is our experience that even fewer than the 25.8% cited by Fleisher et al may indeed know that they have been found to have and been treated for STD. This is especially true for those infected with chlamydia, trichomonas, and venereal warts (human papillomavirus). Given the importance and difficulty in obtaining a good general medical history for adolescents, it is likely that there is often less information
McHugh MT, Palusci VJ. Assessing Prior History of Sexually Transmitted Disease. JAMA. 1992;267(12):1610-1611. doi:10.1001/jama.1992.03480120048020