Abstract
Background
This study examined whether sexually transmitted infection (STI) testing patterns aligned with U.S. Prevention Services Task Force (USPSTF) screening recommendations among a large sample of U.S. adolescents.
Methods
Data were from Inclusive Care and Access to Resources for Everyone, a cross-sectional online survey of adolescents (13–17 years old) recruited from December 2022 to April 2024. The analytic sample included participants who disclosed sexual activity history to a provider (N = 785). Participants reporting ever receiving STI testing selected which STIs they were tested for at their most recent test. We assessed whether reported STIs at most recent testing visit aligned with USPSTF screening recommendations: chlamydia and gonorrhea for females 15 years and older; syphilis for females with additional risk factors and all males; or not (i.e. all other STIs). Stratified by sex, we calculated frequencies, prevalence ratios (PR) comparing testing versus no testing, and 95% confidence intervals (CI).
Results
More females reported chlamydia and gonorrhea testing (33.4%, n = 214) than syphilis testing (20.1%, n = 131). A similar prevalence rate of syphilis testing was reported among males (17.8%, n = 24). One in five females (19.2%, n = 125) and one in four males (27.8%, n = 37) tested for STIs that did not have screening recommendations. Females who used a substance in the past 30 days (PR = 1.6, 95% CI 1.1–2.3) and males identifying as transgender/non-binary/another gender (PR = 3.1, 95% CI 1.5–6.5) reported higher testing prevalence rates for syphilis than their counterparts.
Conclusions
Adolescent STI testing was low and minimally followed USPSTF recommendations. Strategies to promote adolescent STI screening and adherence to USPSTF guidelines are needed.