title: Annual physical examination reports vary by gender once teenagers become sexually active.
abstract: BACKGROUND
  Few sexually active male adolescents receive sexual and reproductive health (SRH) services. To understand this, we examined the association between sexual behavior status and physical examination of the adolescents over time.
  
  
  METHODS
  We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9,239 adolescents who completed the baseline school (1994/1995) and wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate = 71%). The logistic regression models were fitted with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, compared with baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors.
  
  
  RESULTS
  In all, 34.5% of male and 38.2% of female adolescents reported experiencing vaginal intercourse by follow-up, and 22.4% of male and 24.7% of female adolescents reported first experiencing intercourse during the study period. Among sexually active adolescents, about half reported having annual physical examinations and one-fifth reported not having any physical examinations. Among female adolescents, baseline to follow-up examination reports significantly increased in the following: sex initiators (adjusted odds ratio [OR] = 2.09, 95% confidence interval [CI] = 1.66-2.64); those reporting sex at both times (OR = 2.16, CI = 1.51-3.09); and those reporting no sex either time (OR = 2.47, CI = 2.00-3.04). Among male adolescents, baseline to follow-up examination reports significantly increased in those reporting no sex either time (OR = 1.57, CI = 1.26-1.96) and showed increasing trends in sex initiators (OR = 1.27, CI = .92-1.76).
  
  
  CONCLUSIONS
  A majority of sexually active adolescents report annual physical examinations over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase access of all adolescents to SRH services. MESH TERMS: Health Services Accessibility, Male, Female.
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, The Johns Hopkins University, Baltimore, Maryland, USA. amarcell@jhsph.edu
authors.forename: Arik V
authors.initials: AV
authors.lastname: Marcell
authors.forename: Pam
authors.initials: P
authors.lastname: Matson
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Ellen
authors.forename: Carol A
authors.initials: CA
authors.lastname: Ford
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010808:Physical Examination; D034121:Reproductive Health Services / Q000706:statistics & numerical data; D012737:Sex Factors; D012725:Sexual Behavior