Article Text

  1. C. A. Miller,
  2. K. Tebb,
  3. J. Neuhaus,
  4. M. A. Shafer
  1. Department of Pediatrics, University of California, San Francisco, San Francisco, CA


Purpose As many teens utilize only urgent care visits each year, these visits are an important opportunity to screen for sexually transmitted infections (STIs). This study looked at whether aspects of doctor communication in the urgent care setting were associated with teens' reported acceptability of sexual health discussion and urine STI testing.

Methods In this cross-sectional study of 211 adolescents, ages 14-18, attending urgent care visits in two HMO pediatric clinics, participants completed a confidential 22-item self-administered survey post urgent care visit. Teens were asked to rate their provider's communication on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree). Statements included: “The doctor knows how to talk to teens like me”; “The doctor explained that what we talked about alone would be confidential (that is kept between us).” Teens were also asked to rate their acceptability of talking about sexual health during an urgent care visit and providing a urine sample for STI testing in urgent care visits using the same rating scale. For analysis 1, 2 = unacceptable and 3, 4 = acceptable.

Results The overall reported acceptability of sexual health discussion and urine STI testing was 82% and 79% respectively. Using logistic regression analysis, teens' reported acceptability of sexual health discussion was significantly associated with doctors explaining confidentiality to teens (OR 2.80, 95% CI 1.21-6.49, p value = .02), and having a doctor who “knows how to talk to teens like me” (OR 7.47, CI 2.12-26.39, p value = .002). Teens' reported acceptability of urine STI testing was also significantly associated with having a doctor who “knows how to talk to teens like me” (OR 4.35, CI 1.31-14.51, p value = .02) but was not significantly associated with the doctor's explanation of confidentiality. These associations did not vary by gender.

Conclusions Sexual history taking and collecting urine samples for testing are components of screening for STIs and were reported as acceptable to most teens in the urgent care setting. Aspects of doctor communication were associated with reported acceptability of sexual heath discussion and urine STI testing and therefore represent an area that can be targeted for provider education as pediatric practices expand STI screening to urgent care visits.

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