青少年健康监督访视期间性传播疾病、人类免疫缺陷病毒及妊娠预防服务的错失机会。

Missed opportunities for sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention services during adolescent health supervision visits.

作者信息

Burstein Gale R, Lowry Richard, Klein Jonathan D, Santelli John S

机构信息

Division of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.

出版信息

Pediatrics. 2003 May;111(5 Pt 1):996-1001. doi: 10.1542/peds.111.5.996.

DOI:10.1542/peds.111.5.996

PMID:12728079

Abstract

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.

摘要

目的

描述在初级保健机构中，有性经历的青少年接受的关于妊娠和性传播疾病（包括人类免疫缺陷病毒[HIV]）的预防咨询情况，并检验近期性风险行为与预防咨询之间的关联。

方法

利用1999年青少年风险行为监测调查的数据，该调查是一项对高中生进行的具有全国代表性的调查（N = 15349），我们分析了关于性经历、自上次预防性保健就诊以来的时间，以及在他们上次预防性保健就诊期间与医生或护士讨论性传播疾病、HIV或妊娠预防问题的回答。采用逻辑回归检验关联；对学生的人口统计学特征进行了控制。

结果

在接受调查的美国高中生中，超过一半的学生报告在调查前12个月内进行过预防性保健就诊：60.4%（95%置信区间[CI]：57.2% - 63.6%）的女生和57.5%（95%CI：53.9% - 61.1%）的男生。对于女生，性经历与预防性保健就诊呈正相关（比值比[OR]：1.3；95%CI：1.1 - 1.6），但对于男生，性经历有负面影响（OR：0.8；95%CI：0.7 - 0.9）。在调查前12个月内报告进行过预防性保健就诊的学生中，42.8%（95%CI：38.6% - 47.1%）的女生和26.4%（95%CI：22.7% - 30.2%）的男生报告在这些就诊中讨论过性传播疾病、HIV或妊娠预防问题。一旦学生进入医疗保健系统，性经历与进行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）。