Mandell David S, Eleey Catharine C, Cederbaum Julie A, Noll Elizabeth, Hutchinson M Katherine, Jemmott Loretta S, Blank Michael B
Center for Mental Health Policy and Services Research, Department of Psychiatry, University of Pennsylvania School of Medicine, 3535 Market St, 3rd Floor, Philadelphia, PA 19104, USA.
J Sch Health. 2008 Jul;78(7):382-8. doi: 10.1111/j.1746-1561.2008.00318.x.
To estimate the relative risk of sexually transmitted infections (STIs) among children identified as having learning disabilities through the special education system.
This cross-sectional study used special education data and Medicaid data from Philadelphia, Pennsylvania, for calendar year 2002. The sample comprised 51,234 Medicaid-eligible children, aged 12-17 years, 8015 of whom were receiving special education services. Claims associated with diagnoses of STIs were abstracted, and logistic regression was used to estimate the odds of STI among children in different special education categories.
There were 3% of males and 5% of females who were treated for an STI through the Medicaid system in 2002. Among females, those in the mental retardation (MR) category were at greatest risk (6.9%) and those in the emotionally disturbed or "no special education" category at lowest risk (4.9% each). Among males, STIs were most prevalent among those classified as mentally gifted (6.7%) and lowest among those in the MR category (3.0%). In adjusted analyses, males with specific learning disabilities and females with MR or who were academically gifted were at excess risk for STIs.
The finding that children with learning disabilities are at similar or greater risk for contracting STIs as other youth suggests the need to further understand their risk behaviors and the potential need to develop prevention programs specific to their learning needs.
评估通过特殊教育系统被认定为有学习障碍的儿童感染性传播感染(STIs)的相对风险。
这项横断面研究使用了宾夕法尼亚州费城2002年日历年的特殊教育数据和医疗补助数据。样本包括51234名符合医疗补助条件、年龄在12至17岁的儿童,其中8015名正在接受特殊教育服务。提取与性传播感染诊断相关的索赔数据,并使用逻辑回归来估计不同特殊教育类别的儿童感染性传播感染的几率。
2002年,通过医疗补助系统接受性传播感染治疗的男性为3%,女性为5%。在女性中,智力发育迟缓(MR)类别中的女性风险最高(6.9%),情绪困扰或“无特殊教育”类别中的女性风险最低(均为4.9%)。在男性中,性传播感染在被归类为智力超常的人群中最为普遍(6.7%),在智力发育迟缓类别中的男性中最低(3.0%)。在调整分析中,患有特定学习障碍的男性以及患有智力发育迟缓或学业超常的女性感染性传播感染的风险更高。
有学习障碍的儿童感染性传播感染的风险与其他青少年相似或更高,这一发现表明有必要进一步了解他们的风险行为,以及可能需要针对他们的学习需求制定预防计划。