Health care utilization in homeless youth.

To examine common reasons for utilization of health care services at a free homeless youth clinic. This is a retrospective chart review for visits over a 1 year period. Data on age, gender, and up to 3 chief complaints per visit were collected from the electronic medical record. Of the 744 clinical encounters, the mean age of youth was 18.8 years and 53.2% involved female patients. The most common reasons for utilizing services include screening and treatment of sexually transmitted infections (STI) 14.3%, physical exam for housing 13.7%, dermatologic complaints 13.5%. Chief complaints were different for males and females (p ≤ 0.001). Females were more likely to receive laboratory testing for STI than males (p ≤ 0.001). Females were most likely to seek care for sexual and reproductive health needs and males were more likely to come for acute concerns. These differences can inform providers working with this vulnerable population.

Generation C: prevalence of and risk factors for chlamydia trachomatis among adolescents and young women in Lima, Peru.

OBJECTIVE: Adolescent and young adult women in urban, socioeconomically disadvantaged areas are at high risk of contracting sexually transmitted infections (STIs). We assessed associations of Chlamydia trachomatis (CT) infection with both traditional STI risk factors, and partner and partnership-related factors among low-income women in Lima, Peru, by age group. METHODS: In a cross-sectional analysis of CT infection among 1290 postpartum women, cervical swabs were collected for CT polymerase chain reaction (PCR) within 48 h after delivery, and a structured interview was completed. Multivariate logistic regression was used to evaluate risk factors for CT, with separate models stratified by age: adolescents (12-19 years), young women (20-24 years), and older women (>or=25 years). RESULTS: CT was detected in 9.6% of adolescents, 9.0% of young women, and 5.4% of older women (p = 0.03). Among adolescents, history of drug use (odds ratio [OR] = 5.62, 95% confidence interval [CI] 1.03-30.6) and short duration of current partnership (OR = 2.6, 95% CI 1.14-5.93) were the strongest predictors of CT infection. Among young women, younger age at coitarche (OR = 0.74 for each year older, 95% CI 0.60-0.91) and low income (OR = 2.40, 95% CI 1.04-5.55) were associated with CT, while self-report of ever using condoms was protective (OR = 0.22, 95% CI 0.08-0.61). Among older women, only younger age at coitarche was related to CT (OR = 0.85, 95% CI 0.75-0.97). CONCLUSIONS: Risk factors for CT among women in Lima, Peru, differed for adolescents, young women, and older women, which may reflect differences in biology and/or immunology of CT as well as variability in the occurrence of specific risk behaviors by age group.