Rates of screening for sexually transmitted infections in adolescents with and without disabilities

Nili Amir; Kathleen E O'Brien; Susan J Woolford; Cheyney C Dobson; Harlan McCaffery; Niko A Kaciroti; Richard Eikstadt; Monica W Rosen

doi:10.1016/j.jpag.2025.01.001

Rates of screening for sexually transmitted infections in adolescents with and without disabilities

J Pediatr Adolesc Gynecol. 2025 Jan 7:S1083-3188(25)00001-4. doi: 10.1016/j.jpag.2025.01.001. Online ahead of print.

Authors

Nili Amir¹, Kathleen E O'Brien², Susan J Woolford³, Cheyney C Dobson³, Harlan McCaffery³, Niko A Kaciroti⁴, Richard Eikstadt³, Monica W Rosen⁵

Affiliations

¹ Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT.
² Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
³ Department of Pediatrics, University of Michigan, Ann Arbor, MI; Program for Equity in Child and Adolescent Health, Michigan Medicine, Ann Arbor, MI.
⁴ Department of Pediatrics, University of Michigan, Ann Arbor, MI; Program for Equity in Child and Adolescent Health, Michigan Medicine, Ann Arbor, MI; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI.
⁵ Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI. Electronic address: mwoll@med.umich.edu.

PMID: 39788368
DOI: 10.1016/j.jpag.2025.01.001

Abstract

Background: Individuals with disabilities experience a higher prevalence of sexually transmitted infections (STIs) compared to their counterparts without disabilities; however, there is limited data on whether they are screened for STIs at the same rate. The aim of this study was to determine whether adolescents and young adults with disabilities undergo routine screening for STIs at lower rates than individuals without disabilities.

Methods: We performed a retrospective cohort study of female patients aged 16-21 years who were seen between July 2021 and August 2023 by pediatrics, internal medicine/pediatrics, or family medicine at a single institution. Disability status was determined via ICD-10 codes. STI testing information was obtained by chart review. Data were analyzed using multiple logistic regression, and adjusted odds ratios were reported for race, ethnicity, age, and disability.

Results: Among 6906 eligible patients, 90 (1.3%) had a disability. Individuals with disabilities underwent STI screening at lower rates (60% vs 77.2%, p<.001). There were lower odds of STI screening for individuals with any disability (aOR 0.38, 95% CI 0.24-0.61, p<.001), a physical disability (aOR 0.26, 95% CI 0.09-0.72, p=.008), or an intellectual disability (aOR 0.37, 95% CI 0.21-0.64, p<.001) when adjusting for race, ethnicity, and age.

Conclusions: The rate of STI screening among adolescents and young adults with disabilities was lower compared to those without disabilities. Universal testing may help normalize STI screening so that individuals with a higher risk of STIs are not missed. Further research is indicated to identify and mitigate factors that lead to lower rates of screening.

Keywords: Disability; Gynecology; Health Disparities; Sexually Transmitted Infections.