What sexually transmitted disease screening method does the adolescent prefer? Adolescents' attitudes toward first-void urine, self-collected vaginal swab, and pelvic examination.

OBJECTIVE: To assess sexually active adolescents' attitudes toward 3 screening collection techniques for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis using first-void urine (FVU), self-collected vaginal swab specimens, and pelvic examination with clinician-collected endocervical swab specimens. DESIGN: Participants completed a preexamination health survey, provided FVU and self-collected vaginal swab samples, and had a pelvic examination with endocervical swab specimen collection. In a confidential postexamination interview, patients ranked the 3 screening techniques according to preference and responded to qualitative positive and negative descriptors to evaluate each technique. SETTING: San Francisco area health maintenance organization and university clinics. PARTICIPANTS: A convenience sample of 155 ethnically diverse females aged 12 to 21 years, who were sexually active and were to have a pelvic examination. MAIN OUTCOME MEASURES: Adolescents' preferences for and evaluations of 3 sexually transmitted disease screening techniques. RESULTS: Participants preferred the FVU test for sexually transmitted disease screening over the pelvic examination and the self-administered vaginal swab test (P<.001). These results were consistent when controlling for potentially mitigating experiences, including previous pelvic examination, tampon or condom use, and prior pregnancy. In evaluating what they liked and disliked about each of the 3 screening methods, participants described the FVU most positively, the pelvic examination most negatively, and the vaginal swab technique slightly less positively than the FVU. CONCLUSION: Most sexually active adolescents attending clinics for pelvic examination prefer to be screened for sexually transmitted diseases first by the FVU, second by the self-collected vaginal swab test, and last by the pelvic examination.

Home STI testing: the adolescent female's opinion.

PURPOSE: To assess sexually active adolescent females' attitudes of home tests for sexually transmitted infections. METHODS: This study represents a follow-up to a study on adolescent attitudes toward different sampling methods for STI testing. In the initial study participants completed a pre-examination health survey, provided first void urine (FVU) and self-collected vaginal swab samples followed by a pelvic examination with STI screening by endocervical swabs. Participants' attitudes about the three collection techniques were assessed at the end of the visit. For the current study, this same group of ethnically diverse adolescents (13-20-years-old) was contacted by telephone 9 months after their initial clinic visit to re-assess their attitudes about the three specimen collection techniques and to evaluate their attitudes regarding the use of home STI testing. Friedman tests of mean ranks evaluated teens' rankings of STI sampling methods and multivariate regression analysis was used to identify predictors of home test preference. RESULTS: Home urine testing was the first choice for STI screening followed by the FVU, self-obtained vaginal swab and endocervical swab collected in a clinical setting. FVU was preferred to self-collected vaginal swabs (p = .01). Adolescents who worried about having an STI were more likely to favor home urine testing (OR 5.5, p = .01). Only 22% would seek any STI screening if asymptomatic. CONCLUSIONS: Because young women preferred home STI testing, this may be an additional option, as the foundation for such testing kits has progressed. Adolescent preferences may be heavily influenced by the pelvic examination experience. Because of the largely asymptomatic nature of CT infections, multiple screening options (clinical and home-based) need to be available to increase access to care.