Missed opportunities for sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention services during adolescent health supervision visits
Missed opportunities for sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention services during adolescent health supervision visits
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DOI：
10.1542/peds.111.5.996
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发表时间：
2003-05-01
期刊：
影响因子：
8
通讯作者：
Santelli, JS
中科院分区：
文献类型：
--
作者：
Burstein, GR;Lowry, R;Santelli, JS
Objective.描述有性经验的青少年在初级保健环境中接受的有关怀孕和性传播疾病（STDs）（包括人类免疫缺陷病毒（HIV））的预防咨询，并测试最近的性风险行为与预防咨询之间的关联。方法。使用1999年青年危险行为监测调查的数据，一个全国性的代表性调查（N = 15 349）的高中生，我们分析了有关性经验的问题，时间，因为最后一次预防性保健访问，并讨论性病，艾滋病毒，或怀孕预防与医生或护士在他们的最后一次预防性保健访问。采用Logistic回归分析，控制学生的人口统计学特征。超过一半的受访美国高中生在调查前12个月内报告了预防性医疗保健访问：60.4%（95%置信区间[CI]：57.2%-63.6%）的女学生和57.5%（95% CI：53.9%-61.1%）的男学生。对于女学生，性经验与预防性保健访问呈正相关（比值比[ OR]：1.3; 95%CI：1.1-1.6），但对于男学生，性经验有负面影响（OR：0.8; 95%CI：0.7-0.9）。在调查前12个月内报告进行过预防保健访问的学生中，42.8%（95% CI：38.6%-47.1%）的女生和26.4%（95% CI：22.7%-30.2%）的男生报告在这些访问中讨论过性病、艾滋病毒或预防怀孕。性经历与学生进入卫生保健系统后参与性健康对话的可能性更高相关：女生（OR：3.8; 95%CI：3.0-4.9）和男生（OR：1.9; 95%CI：1.3-2.7）。初级保健提供者错过了向高危青年提供性病、艾滋病毒和怀孕预防咨询的机会。
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).Conclusion. Primary care providers miss opportunities to provide STD, HIV, and pregnancy prevention counseling to high-risk youth.