Body art among minority high school athletes: prevalence, interest and satisfaction; parental knowledge and consent.

Of 997 minority high school students, 8.6% had tattoos and 8% piercings (excluding earlobes); 21% with tattoos and 59% with piercings would not repeat the experience. Fifty-eight percent with tattoos and 43% with piercings reported parental knowledge before the procedure; 75% and 80%, respectively, were asked for proof of parental consent.

Condom use in incarcerated adolescent males: knowledge and practice.

BACKGROUND: Information is limited on how well adolescents use condoms and where they learn how. OBJECTIVE: The objective of this study was to determine how often incarcerated males used condoms incorrectly and where, how, and from whom they learned condom use. STUDY: This study consisted of an interviewer-administered survey during intake physicals at a juvenile detention center. Results were based on self-report; condom use models were not used. RESULTS: During usual use among 141 males, errors included failure to secure the condom to the penis on withdrawal (37%), loss of erection before condom removal (18%), and failure to leave space at the tip (14%). Learning occurred at home (27%), school (23%), probation/detention facilities (14%), and community programs (3.4%). Subjects learned from educators/counselors (37%), family (27%), and friends (6.9%). Methods of learning included reading the package insert (45%), demonstrations (39%), explanations (33%), and media (19%). CONCLUSIONS: These adolescents had relatively few condom errors. Common methods of learning correct condom use included observing a demonstration, reading the package insert, and hearing an explanation. The last 2 methods are easy to implement.

Negative pregnancy tests in urban adolescents: an important and often missed opportunity for clinicians.

This study describes a project to determine the incidence of negative pregnancy tests performed in an urban community for teens 18-years old and younger. Pregnancy test logs were kept at a variety of clinical agencies for a three-month period. Five hundred and fifty urine pregnancy tests were performed; 77% were negative. In our community a large number of teens are accessing health care services for pregnancy tests, the vast majority of which are negative and represent an important opportunity to prevent unintended pregnancies in a population of adolescent girls.

Projected economic costs due to health consequences of teenagers' loss of confidentiality in obtaining reproductive health care services in Texas.

BACKGROUND: We wanted to focus on the potential consequences of recently enacted legislation in Texas that limits adolescents' ability to obtain confidential reproductive health care services. OBJECTIVE: To assess the potential economic costs that result when adolescents do not seek reproductive health care services because their confidentiality is compromised. DESIGN: We developed a cost model to estimate the projected costs of parental consent and law enforcement reporting requirements based on data from the literature, the Texas Department of Health, and publicly funded family planning clinics in Texas. Univariate and multivariate sensitivity analyses explored different scenarios. SETTING: The state of Texas. PARTICIPANTS: Projected costs were estimated for all girls younger than 18 years using publicly funded reproductive health care services in Texas. MAIN OUTCOME MEASURES: We determined the projected number of additional pregnancies, births, abortions, and untreated sexually transmitted infections and resulting pelvic inflammatory disease and calculated the associated economic costs of these projected outcomes. RESULTS: The potential costs of parental consent and law enforcement reporting requirements in Texas were estimated at 43.6 million dollars (range, 11.8 million dollars to 56.6 million dollars) for girls younger than 18 years currently using publicly funded services. CONCLUSIONS: As policymakers throughout the United States search for ways to curtail adolescent sexual activity and its adverse consequences, this analysis suggests that the limiting of medical confidentiality and the resulting restricted use of reproductive health care services potentially have serious health and economic consequences.

Self-assessment of circumcision status by adolescents.

In epidemiologic studies of the relation between circumcision and sexually transmitted infections, it is necessary to rely on self-report of circumcision status. The purpose of this 2002 study in Houston, Texas, was to determine whether adolescent males could make correct self-reports. During physical examinations, adolescents were asked whether they were circumcised. The authors then examined the adolescents' genitalia. Circumcision status was recorded as complete (glans penis fully exposed), partial (glans partly covered), or uncircumcised (glans completely covered). The mean age of the 1,508 subjects was 15.0 (standard deviation, 1.63) years; 64% were Black, 29% Hispanic, and 7% White. Forty-nine percent had full, 1% partial, and 50% no circumcision. Of the 738 fully circumcised subjects, 512 (69%) considered themselves circumcised, 54 (7%) considered themselves uncircumcised, and 172 (23%) did not know. Of the 751 uncircumcised youth, 491 (65%) described themselves as uncircumcised, 27 (4%) reported being circumcised, and 233 (31%) did not know. The sensitivity of self-report among those who thought they knew their status was 90.5%, and the specificity was 94.8%; 27% did not know their status. In this population, self-report of circumcision status did not result in accurate information mainly because many adolescents were unsure of their status.

Posttraumatic stress disorder and substance use in inner-city adolescent girls.

The purpose of this study is to examine rates of nicotine, marijuana, and alcohol use as well as patterns of problematic substance use and posttraumatic stress disorder (PTSD) symptoms in inner-city adolescent girls. One hundred four adolescents who obtained medical care at a hospital-based adolescent clinic were systematically surveyed for trauma exposure, posttraumatic stress symptoms, and substance use. A subset (N = 54, 52%) of girls completed a semistructured psychiatric diagnostic interview (K-SADS-PL) to ascertain timing of PTSD symptoms relative to substance use. Compared with traumatized girls without PTSD, girls with full and partial PTSD were significantly more likely to use nicotine, marijuana, and/or alcohol on a regular basis. Fifteen girls met criteria for both PTSD and a substance-use disorder. For 80% of these girls, the age of onset of PTSD was either before or concurrent with the onset of their substance-use disorder. Inner-city adolescent girls with PTSD exhibit problematic substance use and may be at high risk of developing a comorbid substance-use disorder.

Effective contraceptive counseling with adolescents in a nurse-based setting.

Nurses serve a critical role in working with adolescents on reproductive health issues. Nurses must be knowledgeable and comfortable with providing counseling on contraceptive choices and decision making in order to meet the important goal of helping teens prevent unintended pregnancies.

How to perform a pelvic exam for the sexually active adolescent.

The pelvic examination is a necessary health screening for sexually active female adolescents. This article describes how to perform a pelvic examination, including collecting specimens for sexually transmitted infections, wet mount evaluation, and the Papanicolaou test. Additional sections cover abnormal findings and special considerations.

Prevalence and incidence of pelvic inflammatory disease in incarcerated adolescents.

BACKGROUND: Few recent studies have determined the prevalence and incidence of pelvic inflammatory disease (PID) among adolescents. GOAL: The goal of this study was to determine these parameters among incarcerated youths. STUDY DESIGN: Both on admission and during incarceration, consecutive adolescents entering the Harris County, Texas, Juvenile Detention Center were evaluated for symptoms of PID. One of two experienced clinicians examined adolescents with possible PID. For the diagnosis of PID, we used the minimal criteria of the CDC. RESULTS: In sexually active heterosexual or bisexual adolescents (N = 313), the prevalence of PID at admission was 4.5%; during the first 31 days of incarceration, the incidence density of PID was 3.3 cases/100 person-months, and the cumulative incidence was 2.2%. The prevalence among these youths of chlamydial and/or gonorrheal infection, as determined by urine or cervical testing, was 24.9%. CONCLUSION: The high prevalence and incidence of PID underscore the need for effective programs to eradicate chlamydial and gonorrheal infections in high-risk youths.

Pelvic inflammatory disease in adolescents: a review.

Pelvic inflammatory disease is relatively common in sexually active adolescents. Most cases are only mildly symptomatic, and criteria for diagnosis should not be stringent. Although chlamydial or gonorrheal infections or both are common in pelvic inflammatory disease, other aerobic and anaerobic organisms are often also present and may be the only causative agents. Commonly used initial therapy, e.g., ceftriaxone and doxycycline, treats some but not all of these organisms. Patients should be seen within 48 to 72 hours after initiating therapy; lack of improvement suggests noncompliance with antibiotic therapy, the need for broader-spectrum antibiotic coverage, a tubo-ovarian abscess, or a mistake in diagnosis. Important preventive measures include screening of sexually active, asymptomatic adolescents for gonorrheal and chlamydial infections, not only in clinics for sexually transmitted diseases and family planning but also in primary care settings. Urine tests that amplify chlamydial and gonococcal nucleic acid are noninvasive and very accurate.