Miller Melissa K, Pickett Michelle, Leisner Kelsee, Sherman Ashley K, Humiston Sharon G
Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA.
Pediatr Emerg Care. 2013 Aug;29(8):907-11. doi: 10.1097/PEC.0b013e31829ec244.
The objective of this study was to describe sexual health behaviors, as well as prior use of and preferences for sexual health services among adolescents in the pediatric emergency department (ED).
In this cross-sectional study, subjects aged 14 to 19 years who presented to an urban or suburban ED from a single Midwestern hospital system completed a written survey. The survey included questions on previous sexual activity, high-risk behaviors (first sex before age 15 years, no condom at last sex, substance use at last sex, >3 partners in past 3 months, and >4 lifetime partners), and sexual health service use and preferences. Comparisons of responses between subgroups were analyzed using χ2 test. Multiple logistic regression was used to identify factors associated with high-risk behaviors. Care preferences were scored using a 4-point Likert scale; mean scores were ranked.
Subjects included 306 adolescents (85% of approached). The mean age was 15.5 years. Almost half (45%) reported previous sexual activity, and of those, 63% reported 1 or more high-risk behaviors (most commonly first sex before age 15 years [43%] and no condom at last sex [29%]). Almost all wanted to prevent pregnancy, but only one third received birth control counseling before sexual debut, and 14% reported no contraception at last sex. Younger age was associated with 1 or more high-risk behaviors (odds ratio, 3.7; confidence interval, 1.39-9.84). Preferences for care included caring, knowledgeable providers, and low/no cost.
Because of high prevalence of high-risk behaviors among adolescents presenting in the ED, strategies should be developed to link these patients to comprehensive sexual health care.
本研究的目的是描述儿科急诊科青少年的性健康行为，以及他们之前对性健康服务的使用情况和偏好。
在这项横断面研究中，来自中西部一家医院系统的城市或郊区急诊科的14至19岁受试者完成了一份书面调查问卷。该问卷包括有关既往性活动、高危行为（15岁前首次性行为、最近一次性行为未使用避孕套、最近一次性行为时使用毒品、过去3个月内有3个以上性伴侣以及一生中有4个以上性伴侣）以及性健康服务使用情况和偏好的问题。使用χ²检验分析亚组之间的反应差异。采用多因素逻辑回归分析确定与高危行为相关的因素。护理偏好采用4分量表评分；对平均得分进行排序。
研究对象包括306名青少年（占邀请人数的85%）。平均年龄为15.5岁。近一半（45%）的青少年报告有过性活动，其中63%报告有1种或更多高危行为（最常见的是15岁前首次性行为[43%]和最近一次性行为未使用避孕套[29%]）。几乎所有青少年都希望预防怀孕，但只有三分之一的青少年在首次性行为前接受过避孕咨询，14%的青少年报告最近一次性行为时未采取避孕措施。年龄较小与1种或更多高危行为相关（比值比为3.7；置信区间为1.39 - 9.84）。护理偏好包括关怀、知识渊博的医护人员以及低成本或免费。
由于急诊科青少年中高危行为的发生率较高，应制定策略，将这些患者与全面的性健康护理联系起来。
