Missed opportunities for sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention services during adolescent health supervision visits.
OBJECTIVE
To describe prevention counseling on pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), received by sexually experienced youth in the primary care setting and to test associations between recent sexual risk behaviors and preventive counseling.


METHODS
Using data from the 1999 Youth Risk Behavior Surveillance survey, a nationally representative survey (N = 15 349) of high school students, we analyzed responses to questions about sexual experience, time since last preventive health care visit, and discussion of STD, HIV, or pregnancy prevention with a doctor or nurse during their last preventive health care visit. Logistic regression was used to test associations; students' demographic characteristics were controlled.


RESULTS
More than half of the US high school students surveyed reported a preventive health care visit in the 12 months preceding the survey: 60.4% (95% confidence interval [CI]: 57.2%-63.6%) of female students and 57.5% (95% CI: 53.9%-61.1%) of male students. For female students, sexual experience was positively associated with a preventive health care visit (odds ratio [OR]: 1.3; 95% CI: 1.1-1.6), but for male students, sexual experience had a negative effect (OR: 0.8; 95% CI: 0.7-0.9). Of the students who reported a preventive health care visit in the 12 months preceding the survey, 42.8% (95% CI: 38.6%-47.1%) of female students and 26.4% (95% CI: 22.7%-30.2%) of male students reported having discussed STD, HIV, or pregnancy prevention at those visits. Sexual experience was associated with a higher likelihood of engaging in a dialogue about sexual health once a student entered the health care system: female students (OR: 3.8; 95% CI: 3.0-4.9) and male students (OR: 1.9; 95% CI: 1.3-2.7).


CONCLUSIONS
Primary care providers miss opportunities to provide STD, HIV, and pregnancy prevention counseling to high-risk youth.
Division of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. gib5@cdc.gov
Gale R
GR
Burstein
Richard
R
Lowry
Jonathan D
JD
Klein
John S
JS
Santelli
D000163:Acquired Immunodeficiency Syndrome / Q000208:ethnology / Q000517:prevention & control*; D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006266:Health Education / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology / Q000517:prevention & control* / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data