Infrequency of sexually transmitted disease screening among sexually experienced U.S. female adolescents.
BACKGROUND
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.
Fiscus
Lynne C
LC
Departments of Pediatrics and Medicine, University of North Carolina, Chapel Hill, USA.
Ford
Carol A
CA
Miller
William C
WC
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D016497:Adolescent Health Services / Q000592:standards / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003075:Coitus; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage; D008137:Longitudinal Studies; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology