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Selections from Journal Watch Pediatrics and Adolescent Medicine Copyright © 2005 Massachusetts Medical Society. All rights reserved.


Chlamydia trachomatis screening is recommended for sexually active young women, but few seek it, and many clinicians are uncomfortable questioning and testing adolescents. In this follow-up to a study of teen attitudes about clinic-based testing for sexually transmitted infections (STIs), 98 ethnically diverse adolescent females (age range, 13 to 20; 63% of original group) were resurveyed by telephone 9 months after their initial clinic visit. Participants were asked how they felt about (1) the specimen-collection techniques used in the clinic (first-void urine [FVU] sample, self-collected vaginal swab, and pelvic examination with endocervical swab) and (2) home FVU testing.

Of 98 participants, 52% preferred the home-based FVU test for STI screening; clinic-based FVU testing was preferred by 30%, pelvic exam by 12%, and self-collected vaginal swab by 6%. Adolescents who worried about having an STI were significantly more likely to favor home FVU testing. Only 22% of participants indicated that they would seek any kind of STI screening if asymptomatic.


Pelvic examination is a substantive barrier to both partners in the physician–patient dyad. With the advent of new types of tests, young women have increased opportunities to become positive agents in their own reproductive health care. The participants’ indifference toward testing when asymptomatic is a cause for concern, however, as is our lack of information about how an adolescent would interpret a …

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