“The prevalence of sexually active high school students getting tested for an STI in the past year is relatively low, despite national guidelines,” says a coauthor of the study, Nicole Liddon, PhD, a senior health scientist at the Centers for Disease Control and Prevention (CDC). These findings are important, as they provide the first national estimates of annual STI testing among a representative sample of U.S. high school students, she adds.
Adolescents and Young Adults Account for Nearly 1 in 2 New Sexually Transmitted Diseases
STDs (also known as sexually transmitted infections, or STIs) are very common. About 20 million new STD infections occur each year, and almost half of those are among young people between ages 15 and 24, according to the Office of Disease Prevention and Health Promotion (ODPHP). One in four sexually active adolescent females in the United States has an STD.
Study Offers Glimpse Into Teens’ Sexual Activity and STD Testing
Testing teens for STDs is important. The CDC, the American Academy of Pediatrics (AAP), the United States Preventive Services Task Force (USPSTF), and the American College of Obstetricians and Gynecologists (ACOG) all recommend some degree of STI testing for adolescents and young adults. But there’s been very little information about how often testing is actually happening, according to the authors. This study uses responses from a new question that was added to the 2019 national Youth Risk Behavior Survey: “During the past 12 months have you been tested for an STD, other than HIV, such as chlamydia or gonorrhea?” Past surveys included questions about sexual activity but didn’t include any questions about STD testing. The survey is part of the Youth Risk Behavior Surveillance System (YRBSS), which monitors six categories of health-related behaviors that contribute to the leading causes of death and disability among youths and adults. It monitors things like alcohol and drug use, sexual behaviors, tobacco use, unhealthy dietary habits, and inadequate physical activity.
Females and Teens With More Sexual Partners More Likely to Be Tested
Authors analyzed the responses of 2,501 high school students who reported being sexually active in the previous three months. Their findings included:
Only 20.4 percent reported being tested in the past year, which included 26.1 percent of females and 13.7 percent of males.For females, the likelihood of getting tested wasn’t affected by race/ethnicity, sexual identity, or the sex of sexual contacts. But age made a difference: Only 12.6 percent of girls 15 years old and younger were tested, compared with 22.8 percent for 16-year-olds, 28.5 percent for 17-year-olds, and 36.9 percent for 18-year-olds.For males, the likelihood of getting tested was the same regardless of race/ethnicity, sexual identity, age or sex of sexual contacts.Adolescents and teens of either sex were more likely to get tested if they didn’t use condoms the last time they had intercourse, if they used alcohol or drugs during their last sexual encounter, or if they had four or more lifetime sexual partners. Males who first had sex before the age of 13 were more likely to be tested than those who did not: 27.1 percent versus 12.1 percent.
Who Should Be Tested?
The CDC recommends annual screening for chlamydia and gonorrhea for all sexually active women under 25 years of age, says Dr. Liddon. “At least annual testing is recommended for chlamydia, gonorrhea, and syphilis for young men who have sex with men (YMSM), and testing of young men who have sex with women is recommended on the basis of the type of STI, individual risk behaviors, and the prevalence of infection in their community,” she says. An overview of all the STD screening recommendations can be found on the CDC website.
Better Education and Routine Screening Could Help More Teens Get Tested
Certain strategies could improve the STI testing rate in adolescents and teens, starting with encouraging providers to implement routine screening, says Liddon. “Heathcare clinics, individual providers, and parents can ensure adolescents receive private time with their provider during preventive care visits in order to have important conversations about a patient’s sexual activity,” she says. Liddon also emphasizes the need for education. “We can increase adolescents’ knowledge of the need for STI testing, where to get tested, and their right to self-consent for confidential services like STI testing. Schools can teach adolescents about the importance of STI testing and connect young people to testing and other health services,” she says. Cost, lack of transportation, and stigma can all prevent adolescents from seeking STI testing, and so finding ways to address those barriers is also important, Liddon says.
