ABSTRACT
Offering rapid HIV testing improves rates of testing in adults, but little is known about whether offering adolescents a choice of testing methods increases rates of testing. The aims of the study were to determine rates of HIV testing in adolescents when different testing methods were offered and explore factors associated with agreement to be tested for HIV. Participants (n= 200, sexually experienced 13-22 year olds) were recruited from an urban adolescent clinic, completed a 99-item theory-based survey and were offered their choice of venipuncture, rapid fingerstick or rapid oral fluid HIV testing. Approximately half (49.5%) agreed to HIV testing. Male gender, parental completion of high school, intention to test for HIV if offered by clinician and higher perceived likelihood of current HIV infection were independently associated with agreement to test. Combining new strategies, such as opt-out testing, with routine testing may be needed to improve rates of adolescent HIV testing.
Subject(s)
Clinical Laboratory Techniques/methods , HIV Infections/diagnosis , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Blood/immunology , Blood/virology , Cross-Sectional Studies , Female , Humans , Male , Saliva/immunology , Saliva/virology , Surveys and Questionnaires , Young AdultABSTRACT
Sexually transmitted diseases (STDs) are among the top 10 reportable diseases in the United States. Of the more than 12 million cases annually, approximately 3 million occur in adolescents. An estimated two thirds of cases occur in individuals younger than age 25. Almost half of adolescents report ever being sexually active, and approximately one third are currently sexually active. For a number of biologic and psychosocial reasons, sexually active adolescents have the highest rate of STDs of any sexually active age group. They suffer from the acute manifestations of these diseases as well as complications that place them at risk for some significant long-term negative sequelae, such as infertility, chronic pelvic pain, and cancer. This article reviews the reasons for this increased risk and provides updates on the common STDs that affect adolescents.
Subject(s)
Sexually Transmitted Diseases/diagnosis , Adolescent , Female , Humans , Male , Psychosexual Development , Risk Factors , Sex Education , Sexual Behavior , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/psychologySubject(s)
Adolescent Behavior , Contraception Behavior , Sexual Behavior , Adolescent , Adolescent Medicine , Female , HumansSubject(s)
Menstruation Disturbances , Adolescent , Amenorrhea/etiology , Amenorrhea/physiopathology , Brain Neoplasms/complications , Diagnosis, Differential , Female , Humans , Hypogonadism/etiology , Hypogonadism/physiopathology , Menstruation/physiology , Menstruation Disturbances/etiology , Menstruation Disturbances/physiopathology , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/drug therapy , Polycystic Ovary Syndrome/physiopathology , Puberty, Delayed/complications , Puberty, Delayed/physiopathology , Uterine Hemorrhage/etiology , Uterine Hemorrhage/physiopathology , Vagina/abnormalitiesABSTRACT
Practitioners who provide care for adolescents have a unique opportunity to address issues of adolescent sexuality. This article discusses shortcomings in residency training and possible solutions. The role of the practitioner in the office setting, issues of confidentiality and consent, and school-based sexuality education are reviewed.
Subject(s)
Adolescent Behavior , Internship and Residency , Physician's Role , School Health Services/organization & administration , Sex Education , Sexual Behavior , Adolescent , Confidentiality , Humans , Informed Consent , Physicians' OfficesABSTRACT
Adolescents have the highest rate of sexually transmitted disease (STD) of any sexually active age group. This article reviews the biological, psychological, and social factors that place adolescents at increased risk for STDs. The major STDs are reviewed, including epidemiology, clinical presentation, methods of diagnosis, and treatment modalities. In addition, major sequelae of STDs--including pelvic inflammatory disease, perihepatitis, Reiter's syndrome, and disseminated gonorrhea infection--are discussed.
Subject(s)
Sexual Behavior , Sexually Transmitted Diseases/etiology , Adolescent , Child , Female , Humans , Male , Risk , Sexually Transmitted Diseases/drug therapy , Sexually Transmitted Diseases/epidemiologyABSTRACT
The United States has the highest rate of teen pregnancy in the Western world. Although abstinence may be the ideal solution for the prevention of this problem, one half of adolescents in the United States are sexually active. This article reviews the epidemiology of contraception among adolescents, barriers to effective use of contraception, and ways to improve efficacy. Major methods of contraception, including oral contraceptive pills, Norplant, Depo-Provera, condoms, spermicide, sponge, intrauterine device (IUD), diaphragm, and rhythm/periodic abstinence, are discussed along with method-specific issues related to adolescents.
PIP: 50% of adolescents in the US are sexually active by age 17 and by age 20, 77% of females and 86% of males have been sexually active. The average time between the initiation of sexual activity and the pursuit of medical advice about contraception, however, is one year. Even then, many adolescents and youths use contraception only inconsistently or not at all. The high frequency and prevalence of unprotected sexual intercourse in this age group has therefore given the US the highest rate of teen pregnancy in the Western world. Adolescent pregnancy will not be solved by preaching abstinence. More open and informed communication which dispels misconceptions and myths about contraception is instead needed. The authors review the epidemiology of contraception among adolescents, barriers to the effective use of contraception, and ways to improve efficacy. Major methods of contraception, including oral contraceptive pills, Norplant, Depo-Provera, condoms, spermicide, sponge, IUD, diaphragm, and rhythm/periodic abstinence are discussed along with method-specific issues related to adolescents.
Subject(s)
Adolescent Behavior , Contraception/statistics & numerical data , Adolescent , Attitude of Health Personnel , Contraception/adverse effects , Contraception/methods , Evaluation Studies as Topic , Female , Health Knowledge, Attitudes, Practice , Health Surveys , Humans , Male , Pregnancy , Pregnancy in Adolescence/statistics & numerical data , United StatesABSTRACT
Adolescents are becoming sexually active at younger ages. One half of the adolescents in the United States are sexually active. This article reviews adolescent sexual activity, including rates of sexual activity, sexual practices, gay and lesbian youth, and factors affecting the initiation of sexual activity. In addition, adolescent pregnancy, with possible outcomes and effects on teen parents and their offspring, is discussed.
Subject(s)
Adolescent Behavior , Psychology, Adolescent , Sexual Behavior , Adolescent , Child , Female , Homosexuality , Humans , Male , Pregnancy , Pregnancy Outcome , Pregnancy in Adolescence/statistics & numerical data , United StatesABSTRACT
Ninety-seven asymptomatic 16-21-year-old sexually active adolescent males were evaluated for gonorrhea and chlamydia by culture, chlamydia enzyme immunoassay, and an analysis of a random urine sample for pyuria using centrifuged urine and urine cytometer. The incidence of gonorrhea was 5.3% and chlamydia by culture 12.3%. Immunoassay was superior in sensitivity and specificity (75% and 99%, respectively) to centrifuged urine (sensitivity 58%, specificity 92%) or urine cytometer (58% and 91%) in identifying asymptomatic chlamydia urethritis. Chlamydia enzyme immunoassay is an acceptable, more rapid, and less expensive alternative to culture. The absence of pyuria in asymptomatic males cannot be assumed to indicate the absence of a sexually transmitted disease.
Subject(s)
Chlamydia Infections/prevention & control , Mass Screening/methods , Adolescent , Adult , Chlamydia Infections/epidemiology , Chlamydia Infections/microbiology , Chlamydia trachomatis , Flow Cytometry , Humans , Immunoenzyme Techniques/standards , Male , Mass Screening/standards , Ohio/epidemiology , Prevalence , Sensitivity and Specificity , Urine/microbiology , Vocational EducationABSTRACT
Gynecologic issues are an important part of the medical care of adolescent females. All diagnostic possibilities must be considered in assessing such patients. It is vital that pediatricians feel comfortable approaching these issues and provide reassurance and expertise to their adolescent patients.
