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Features a study which investigated the proportion of sexually experienced African American adolescents who report having undergone screening for sexually transmitted diseases (STD) in San Francisco, California. Integration of STD screening into primary care visits; Percentage of African American women tested for STD; Methodology; Results and discussion; Limitations of the study.

The article presents a study which determined how often primary care physicians ask adolescents about smoking in California. A mailed questionnaire was used to survey a stratified random sample of community-based, board-certified, specialists in pediatrics, family practice, and internal medicine who practice in California and spend at least 50% of their patient care time in primary care. The final sample included only physicians who graduated from medical school in the United States from 1970 through 1985. All anaIysis were performed with the use of data weighted by the actual number of male and female providers in each specialty in California. Overall, the rates of screening younger adolescents for reguIar smoking were higher among female than among male physicians during routine visits. Multivariate analyses revealed significant associations between measured physician attitudes and variations in rates of screening for regular smoking during a routine history and physical exam. Rates of screening younger adolescents were highest among physicians who had more positive attitudes towards adolescents and more positive attitudes towards smoking cessation.

This paper examines the effect of socioeconomic position on the differences in the 3-year rates (1990 to 1992) of reported cases of gonorrhea and chlamydia between Black and White adolescents, aged 12 to 20 years, residing in San Francisco. The crude relative risks for Blacks were 23.4% (95% confidence interval [CI] = 20.4, 27.8) for gonorrhea and 9.3 (95% CI = 8.3, 10.3) for chlamydia. Adjusting for poverty and occupational status, the relative risks were 28.7 (95% CI = 22.5, 36.1) for gonorrhea and 8.9 (95% CI = 7.4, 10.6) for chlamydia. This study demonstrates that factors other than poverty and occupational status account for the racial/ethnic differences in the rates of gonorrhea and chlamydia among adolescents in San Francisco. [ABSTRACT FROM AUTHOR]

Background: In sexual networks, bridge members engaging in discordant partnering play key roles in maintaining and transmitting sexually transmitted infections (STIs) within a population. Goal: The goal was to characterize adolescents likely to engage in discordant sexual relationships with main and casual sex partners. Study Design: Egocentric data about adolescents and their most recent sex partner(s) collected over 6 months were analyzed with use of logistic regression. Results: History of STI, drug use, and meeting venue were significantly associated with discordant sexual partnering among high-risk adolescents. Participants with histories of high-risk behavior, e.g., hard drug use or STI, were more likely to have had a recent, dissimilar partner than those with lower-risk profiles. Particular meeting venues, such as clubs and street locations, were more likely to be associated with age-discordant, race-discordant, and drug use-discordant partnerships for females. Conclusion: Bridge members of adolescent sexual networks were more likely to have a history of STI, hard drug use, or meeting their sex partner through particular venues. [ABSTRACT FROM AUTHOR]

Purpose: (a) To examine different methods of assessing pregnancy intention; (b) to identify psychosocial differences between those who indicate pregnancy intentions and those who do not; and (c) to examine the relationship between pregnancy intentions and subsequent pregnancy at 6-month follow-up in nonpregnant (at baseline), sexually experienced adolescent females., Methods: Longitudinal cohort study of 354 sexually experienced female adolescents attending either a STD clinic or HMO adolescent medicine clinic in northern California. Student's t-tests and regressions examined psychosocial differences between females who reported "any" and "no" pregnancy intentions. ANOVAs examined differences among different combinations of pregnancy plans/likelihood. Chi-square analyses assessed associations between baseline pregnancy intentions and subsequent pregnancy., Results: Adolescents' reports of their pregnancy plans and their assessments of pregnancy likelihood differed from one another (chi2 = 50.39, df = 1, p < .001). Pregnancy attitudes and baseline contraceptive use differentiated those with inconsistent pregnancy intentions (Not Planning, but Likely) from those with clear pregnancy intentions (Planning and Likely, and Not Planning and Not Likely) (Pregnancy Attitudes: F [2,338] = 68.96, p < .0001; Contraceptive Use: F [2,308] = 14.87, p < .0001). Suspected pregnancies and positive pregnancy test results were associated with baseline pregnancy intentions (Suspected: chi2 = 19.08, df = 2, p < .01; Positive Results: chi2 = 8.84, df = 2, p = .015)., Conclusions: To reduce adolescent childbearing we must assess pregnancy intentions in multiple ways. Information/education might benefit those female adolescents with inconsistent reports of pregnancy intentions.

Context: Adolescents' dual use of condoms and hormonal contraceptives is low, and the motivations underlying their decisions to combine contraceptives are not understood., Methods: To examine how pregnancy concerns, sexually transmitted disease (STD) concerns and type of sexual partner influence contraceptive use, we recruited 436 sexually experienced adolescents from two clinics. In structured interviews, we asked adolescents to describe their recent partners, their method use, and their pregnancy and STD concerns. Data were analyzed using logistic regression., Results: The odds that adolescents used condoms with main partners were significantly lower among those who used hormonal contraceptives than among nonusers of these methods (odds ratios, 0.4 for young women and 0.3 for young men). With casual partners, no association existed between adolescents' condom and hormonal contraceptive use. Concerns about pregnancy and STDs influenced this association for women with main partners. Among young women who perceived pregnancy as more negative, hormonal contraceptive users had reduced odds of using condoms (0.1). No association existed between use of the two methods among young women whose view of pregnancy was less negative. Young women who perceived themselves to be less at risk of acquiring an STD had reduced odds of using condoms if they were using hormonal contraceptives (0.2). Among young women who perceived themselves to be more at risk of acquiring an STD, no association existed., Conclusions: Adolescents trade off between hormonal contraceptives and condoms according to partner type and perceived risks. Adolescents' dual-method use may improve if providers tailor counseling to adolescents' perceived risk of STDs and pregnancy, and if they address prevention of both as a related decision.