Abstract
Purpose
Adolescents are at high risk for sexually transmitted infections (STIs) and pregnancy.
Since many adolescents have poor access to preventive care, hospitalizations present
a critical opportunity to address adolescents' reproductive health. The purpose of
this study was to assess provision of reproductive health services within a hospital
setting.
Methods
Retrospective study of a consecutive sample of adolescent patients aged 13 years and
older hospitalized on the hospitalist service at a large academic pediatric tertiary
care center. Measures included sexual history documentation, pregnancy and STI testing,
Human papillomavirus immunization status and administration, and provision of contraception.
Results
Only 55% of 150 patients had sexual history documentation, and of those, 47% endorsed
sexual activity. Associations with increased likelihood of sexual history documentation
included female patients (67% vs. 36%, p < .01), hospitalizations for ingestion (71% vs. 48%, p < .01), hospitalizations to hospital medicine compared with critical care (59% vs.
14%, p < .01), and admission note written by an intern compared with a senior resident,
advanced practice provider, or fellow (67% vs. 44%, 29%, 13%, p < .01). Eighteen patients (12%) were tested for STIs. Only 19% of patients due for
human papillomavirus immunization received it. Sixty percent of females received a
pregnancy test. Contraception was provided in two encounters (2% of females).
Conclusions
Results demonstrate a substantial missed opportunity to provide reproductive health
services to hospitalized adolescents. Providers in hospital settings should optimize
the opportunity to screen for sexual activity and reproductive health needs, provide
indicated services, and offer education regarding reproductive health to hospitalized
adolescents.
Keywords
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Article info
Publication history
Published online: March 13, 2019
Accepted:
January 3,
2019
Received:
November 2,
2018
Footnotes
Conflicts of interest: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2019 Society for Adolescent Health and Medicine. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Caring for Hospitalized Adolescents: Opportunities to Identify and Address Unmet Reproductive Health NeedsJournal of Adolescent HealthVol. 64Issue 6
- PreviewAdolescents in the U.S. experience disproportionately high rates of sexually transmitted infections (STIs) and unplanned pregnancy compared with other industrialized countries, in part due to unmet reproductive health needs [1–4] Nearly 90% of adolescent pregnancies are unplanned, and 29% end in abortion [5]. Rates of STIs among adolescents remain high and are increasing, with nearly one in four females testing positive for an STI annually [4,6]. In addition, 51% of adolescents in the U.S. are not fully vaccinated against the human papillomavirus (HPV) and adolescents have higher rates of missed opportunities for HPV vaccination than other vaccines [7–9].
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