Doctors not screening teenagers for HIV, STDs

It seems major barriers exist to optimizing adolescents’ sexual health. Despite guidelines issued by the US Preventive Services Task Force, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics, a new study finds that primary care providers screen fewer than 3% of their teenaged patients for sexually transmitted diseases (STDs), test barely 1% for HIV, and have documentation on sexual history in only about 20% of their adolescent charts.

The retrospective, cross-sectional study, presented at the 2013 Pediatric Academic Societies meeting in May, looked at 1,000 randomly selected routine visits by 13- to 19-year-olds to 1 of 29 primary care practices affiliated with a pediatric hospital.

The researchers found that of the 1,000 adolescents, about one-fifth (212) had a documented sexual history and about one-fifth of those (45) were sexually active. Regardless, 2.6% received testing for STDs during the preceding year and 1.1% ever received testing for HIV. Of those who were sexually active, a little more than a third (37.8%) received STD screening and a little more than a fifth (22.2%) received testing for HIV.

The researchers found that physicians were about twice as likely to document their patients’ sexual history if the adolescents were older (aged either 15-16 years or 17-19 years) versus younger (aged 13-14 years). They were almost 7 times as likely to do so if the teenagers were black versus white. The adolescents were almost 14 times more likely to have a documented sexual history if they were cared for by a trainee as opposed to an attending physician, and about twice as likely if they were attended by a nurse practitioner/physician assistant (as opposed to a physician) or by any female (vs male) provider.

Physicians provided STD testing 4 times more often to boys than to girls, 8 times more often to blacks than to whites, and 14 times more often to those with nonprivate versus private insurance.