RESUMO
This study was performed to identify specific high-risk behaviors, such as unprotected oral, anal, and vaginal intercourse and substance abuse, associated with human immunodeficiency virus infection among adolescents attending three diverse clinics located in a localized geographic area: a university-based clinic, a Planned Parenthood clinic, and an inner-city public health clinic (PHC). Six hundred seventy-one female and 207 male adolescents attending one of the three clinics completed a structured questionnaire. Similarities among patients at the clinic sites included high rates of anal intercourse (21%), unprotected vaginal sex (95%), oral sex (73%), and poor communication skills (42%). Some differences appeared as well, including higher rates of homosexual experiences, no birth control use, and having multiple partners among adolescents attending the PHC (p < 0.001). In contrast, adolescents attending either the university-based clinic or the Planned Parenthood Clinic had higher rates of substance abuse around sexual activity than those who attended the PHC (p < 0.001). We conclude that adolescents attending general medical clinics in the San Francisco Bay area engage in high-risk behaviors that place them at risk for transmission of human immunodeficiency virus even though many have had previous education about acquired immunodeficiency syndrome and sexually transmitted disease. Specific risk factors include unprotected receptive anal intercourse, unprotected vaginal intercourse with new and unknown partners, experience in homosexual behavior, high rates of oral sex, multiple partners, poor communication skills, and frequent use of illicit substances in conjunction with sex. The differences found among sites indicate the need for health care providers and prevention programs to provide emphasis on practices specific to the adolescents in their service area.
Assuntos
Comportamento do Adolescente , Infecções por HIV/etiologia , Assunção de Riscos , Comportamento Sexual , Síndrome da Imunodeficiência Adquirida , Adolescente , Instituições de Assistência Ambulatorial , California , Preservativos/estatística & dados numéricos , Comportamento Contraceptivo , Feminino , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Fatores de Risco , Transtornos Relacionados ao Uso de SubstânciasRESUMO
Urethral cultures were obtained from 90 adolescent youth, 16 of whom denied previous sexual activity. Among the sexually active boys was a group of 32 with clinically significant pyuria, consistent with the diagnosis of urethritis, on a first-part urinalysis (FPU) specimen. To relate differences in urethral microflora to sexual activity, 42 sexually active patients with a negative FPU were compared with the never sexually active group. The profile of anaerobic, but not aerobic, bacteria isolated from the urethra was related to the presence or absence of previous sexual activity. Mycoplasma species and Ureaplasma urealyticum were isolated from sexually active patients only, and may be markers of sexual activity in adolescent boys. Of the 32 patients with FPU evidence of urethritis, 22 (69%) had cultures positive for Chlamydia trachomatis, and an additional three (9%) had cultures positive for Neisseria gonorrhoeae. The findings in sexually active patients with a positive FPU were otherwise similar to those of sexually active patients without evidence of urethritis. C. trachomatis appears to be the most important agent of urethritis among adolescent boys with a positive FPU.
Assuntos
Uretra/microbiologia , Uretrite/microbiologia , Adolescente , Adulto , Chlamydia trachomatis/isolamento & purificação , Humanos , Masculino , Mycoplasma/isolamento & purificação , Neisseria gonorrhoeae/isolamento & purificação , Comportamento Sexual , Ureaplasma/isolamento & purificaçãoRESUMO
We investigated the acceptability and reliability of sensitive data collected via computer in adolescent patients. Subjects were 108 adolescent girls (ages 14 to 20 years), randomly assigned to one of three groups: (1) interactive computer interview, (2) face-to-face interview, or (3) self-administered questionnaire. Subjects were queried about their general health and sexual behavior. Adolescents interviewed by computer were more likely than subjects in other groups to state that they enjoyed the survey (P less than 0.001). There were no differences in anxiety or the reporting of sexual behavior among subjects in the three groups. Adolescents who stated that they would prefer a computer interview (40%) said they would be more comfortable with the computer, and perceived the method as being fun, interesting, confidential, private, and easy. Computer interviews cannot replace the skills of a sensitive physician, but may be an acceptable and valid means of collecting information from adolescents under certain conditions.
Assuntos
Comportamento do Adolescente , Computadores , Anamnese , Comportamento Sexual , Adolescente , Adulto , Ansiedade , Feminino , Humanos , Entrevistas como Assunto , Inventário de Personalidade , Distribuição Aleatória , Inquéritos e QuestionáriosRESUMO
Adolescent appointment-keeping behavior was investigated prospectively in 245 first-scheduled appointments in a general youth clinic within a pediatric ambulatory setting, to determine if older adolescents were more compliant when they made their appointments and less compliant when their appointments were made by their parents. Among single variables (age, sex, and who made the appointment), rates of kept appointments varied considerably. The highest rates of compliance were found in males, under the age of 15, whose parents made the appointment. The lowest rates were found in females, over the age of 15, who made their own appointment. A multiple regression analysis was used to determine which of the variables was most important in predicting compliance. The most important factor was appointment source. Whether parents make the appointment for their sons and daughters (irrespective of age) was the most important predictor of compliance, emphasizing the importance of parental involvement in scheduling appointments.