Teen clinics: missing the mark? Comparing pregnancy and sexually transmitted infections rates among enrolled and non-enrolled adolescents.
BACKGROUND
In Manitoba, Canada, school-based clinics providing sexual and reproductive health services for adolescents have been implemented to address high rates of sexually transmitted infections (STIs) and pregnancies.


METHODS
The objectives of this population-based study were to compare pregnancy and STI rates between adolescents enrolled in schools with school-based clinics, those in schools without clinics, and those not enrolled in school. Data were from the PATHS Data Resource held in the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy. Adolescents aged 14 to 19 between 2003 and 2009 were included in the study. Annualized rates of pregnancies and positive STI tests were estimated and Poisson regression models were used to test for differences in rates amongst the three groups.


RESULTS
As a proportion, pregnancies among non-enrolled female adolescents accounted for 55 % of all pregnancies in this age group during the study period. Pregnancy rates were 2-3 times as high among non-enrolled female adolescents. Compared to adolescents enrolled in schools without school-based clinics, age-adjusted STI rates were 3.5 times (p < .001) higher in non-enrolled males and 2.3 times (p < .001) higher in non-enrolled females.


CONCLUSIONS
The highest rates for pregnancies and STIs were observed among non-enrolled adolescents. Although provision of reproductive and health services to in-school adolescents should remain a priority, program planning and design should consider optimal strategies to engage out of school youth.
Centre for Global Public Health, University of Manitoba, Winnipeg, Canada. umshaw@myumanitoba.ca.|Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. umshaw@myumanitoba.ca.
Souradet Y
SY
Shaw
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.|Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada.
Colleen
C
Metge
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Carole
C
Taylor
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Mariette
M
Chartier
Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada.
Catherine
C
Charette
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.|Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada.|Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Lisa
L
Lix
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.|Healthy Child Manitoba, Winnipeg, Canada.
Rob
R
Santos
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Joykrishna
J
Sarkar
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Nathan C
NC
Nickel
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Elaine
E
Burland
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Dan
D
Chateau
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Alan
A
Katz
Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.
Marni
M
Brownell
Patricia J
PJ
Martens
D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012572:School Health Services / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*
Out of school youth; STIs; School-based clinics; Teen pregnancies