Receipt of routine gynecological examinations among sexually active female college students in the United States.

AIMS: According to leading medical organizations, it is recommended that all sexually active adolescent females, as well as any woman aged >or=18 years, obtain annual gynecological examinations. This study looked at whether female college students who were sexually active, defined as ever having vaginal intercourse and having one or more sex partner(s) in the past year, received a routine gynecological examination in the past year and whether differences existed in receipt of the examination based on students' age, race/ethnicity, sexual orientation, health insurance status, cigarette smoking (past 30 days), number of sex partners (past year), and gender of sex partners (past year). METHODS: A secondary analysis was conducted with data from the spring 2006 National College Health Assessment. A total of 25,389 sexually active female college students (aged 18-24 years) were included in the analyses. Univariate, bivariate, and multivariate logistic regression analyses were conducted to examine the relationships of variables with receipt of a routine gynecological examination (past year). RESULTS: The majority (75.6%) of sexually active female college students had a routine gynecological examination in the past year. However, students who were younger (aged 18-20 years), Asian or Hispanic, lesbian, only had sex with women (past year), or did not have health insurance were significantly less likely to have had a routine gynecological examination in the past year. CONCLUSIONS: To allow for appropriate intervention, additional research should investigate why different subgroups of sexually active female college students do not obtain routine gynecological examinations. In addition, efforts should be made to link college women who do not have health insurance with no cost or low-cost gynecological services.

STDs among sexually active female college students: does sexual orientation make a difference?

CONTEXT: Research addressing sexual health or STD risk among lesbian and bisexual college women is scarce. METHODS: Data on 29,952 sexually active females aged 18-24 who completed the 2006 National College Health Assessment were examined to assess differences in sexual risk factors and recent STD incidence by sexual orientation. Comparisons were analyzed at the bivariate level and through multivariate logistic regression. RESULTS: Bisexual students were the most likely to have had an STD during the past year (9%); lesbians were the least likely (2%). However, lesbians were also the least likely to have had a routine gynecologic examination (46%, compared with 64-73% of others). Among students who had had multiple partners in the past year, those who had had partners of both sexes were more likely to have had an STD (16%) than were students who had had only male partners (9%) or only female partners (6%). Students who had binged on alcohol the last time they partied, had had multiple partners or had had a routine gynecologic examination in the past year, had been tested for HIV or had not used condoms at last vaginal intercourse were at increased odds of having had an STD (odds ratios, 1.3-4.0). CONCLUSIONS: Sexual health programs targeting female college students, regardless of sexual orientation, must focus on behavioral risks associated with STDs. In addition, the importance of regular gynecologic exams should be emphasized, especially among lesbians. Further research is needed on risk-taking among female college students who are sexually active with both sexes.