Child/Adolescent Health

Adolescents are willing to have chlamydial screening by pediatricians during urgent care visits

Annual screening for Chlamydia trachomatis, the most common bacterial sexually transmitted infection (STI), is recommended for sexually active adolescent and young adult females. Early diagnosis of chlamydial infection is important to prevent reproductive problems such as pelvic inflammatory disease, infertility, and tubal pregnancy. In fact, the 15- to 24-year-old age group has the highest chlamydial infection rates.

Adolescents are willing to be screened for chlamydia during urgent care visits, especially if their clinician can speak their language and clearly explain the meaning of confidentiality, reveals a new study. The fact that adolescents are willing to be screened in this context is important because two-thirds of sexually active adolescents use urgent care visits exclusively for their health care during a given year. Thus, limiting screening to well-care visits will miss the majority of adolescents at risk for chlamydial infection, explain the University of California, San Francisco investigators.

They found that most adolescents found it acceptable to discuss their sexual history (84 percent) and provide urine samples for chlamydial screening (80 percent) during urgent care visits to the pediatrician. Teens who accepted discussion about their sexual history were nearly 3 times more likely to believe that their clinician explained confidentiality, 9 times more likely to believe their clinician knew "how to talk to teens like me," and 14 times more likely to believe the doctor "listened carefully as I explained my concerns." Similarly, teens were nearly four times as likely to be willing to provide a urine sample for chlamydial testing if they thought that their clinician knew "how to talk to teens like me" and "listened carefully as I explained my concerns."

Educating pediatricians and other health care providers such as emergency room physicians in how best to communicate with adolescents may help expand chlamydial screening of this vulnerable group during urgent care visits.

The findings were based on a survey of 365 ethnically diverse adolescents (58 percent were female) aged 13 to 18 receiving urgent care at four pediatric clinics in a large HMO. The study was supported in part by the Agency for Healthcare Research and Quality (HS10537).

More details are in "Chlamydial screening in urgent care visits," by Catherine A. Miller, M.D., Kathleen P. Tebb, Ph.D., Jody K. Williams, M.A., and others, in the August 2007 Archives of Pediatric and Adolescent Medicine 161(8), pp. 777-782.

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