Infrequency of Sexually Transmitted Disease Screening Among Sexually Experienced U.S. Female Adolescents

Abstract

CONTEXT: Since 1993, the Centers for Disease Control and Prevention and professional medical organizations have recommended that all sexually experienced female adolescents receive annual screening for Chlamydia trachomatis. Whether adolescents receive this care is largely unknown. METHODS:Reports of receipt of testing or treatment for a sexually transmitted disease (STD) in the past year, as well as sites of care, were obtained from 3,987 sexually experienced females in grades 7-12 who participated in Wave 1 of the National Longitudinal Study of Adolescent Health, conducted in 1995. Logistic regression was used to determine predictors of reporting care. RESULTS:Eighteen percent of all participants reported having received STD services in the past year. Of those who reported having had a routine physical examination in the past year, 22% reported receipt of STD services. The proportion reporting STD care increased linearly with age from 9% of 12-13-year-olds to 25% of those 19 or older. In adjusted analyses, the odds of reporting testing or treatment were elevated among participants who had had a physical examination in the past year (odds ratio, 2.1), those with Medicaid or Medicare insurance (1.9), black women (1.5) and older adolescents (1.2). Adolescents most often reported having received STD care at a community health center (44%) or a private physician's office (31%). CONCLUSIONS:Continued inadequate screening may contribute to persisting high prevalence of chlamydia infection among adolescents. Future research is needed to determine whether the proportions of adolescents receiving recommended STD screening have increased over time.

Social Disparities in the Receipt of Contraceptive Services Among Sexually Experienced Adolescent Females

“…In contrast, adolescent females who had a mother with less than a high school degree were more likely to have received services than those adolescents who had a mother with a college degree or more. This finding is in accordance with previous studies in which vulnerable populations were more likely to receive reproductive healthcare services (Fiscus et al, 2004;Porter & Ku, 2000;Schuster et al, 1996). Although the lack of social disparities in contraceptive services revealed in this study is encouraging, several factors may play a role in the receipt of reproductive services among vulnerable populations.…”

“…Although few studies have examined social disparities in adolescents' reproductive healthcare (Elster, Jarosik, VanGeest, & Fleming, 2003), evidence suggests that minority (Fiscus, Ford, & Miller, 2004;Porter & Ku, 2000;Schuster, Bell, Petersen, & Kanouse, 1996) and publicly insured adolescents (Fiscus et al, 2004;Porter & Ku, 2000) may be more likely to receive counseling on safer sexual practices (Porter & Ku, 2000;Schuster et al, 1996) and sexually transmitted infection testing (Fiscus et al, 2004;Porter & Ku, 2000) than White and privately insured adolescents. Reasons for the greater receipt of services in these studies may be that providers target certain populations due to concerns over increased risk (Fiscus et al, 2004;Porter & Ku, 2000).…”

Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications

“…In fact, each year after 2008 (beginning of study period) conferred a 26% increase in contraceptive provision compared with preceding year. The higher occurrence of contraceptive provision in our older patients (16-25 years) may have been driven by a bias held by some pediatric providers regarding a perceived low incidence of sexual intercourse [10][11][12] and, by inference, lower teratogenic risk in younger girls (ie, 14-15 years). However, this assumption is inconsistent with established literature.…”

Prevalence Trends in Chlamydial Infections Among Young Women Entering the National Job Training Program, 1998–2004

“…27 Other studies reported even lower chlamydia screening coverage than the national estimate of 60%. 28,29 A study among young female enrollees (aged 16 -26 years) in commercial and Medicaid health plans documented low and minimal increase in screening coverage of chlamydia. 28 The screening coverage for commercial health plans increased from 20% in 1999 to 26% in 2001, and for Medicaid plans, from 28% in 1999 to 38% in 2001.…”