The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, March 11, 2008
P125

Integration of Contraceptive and STD/HIV Services for Young Women in the United States

Sherry L. Farr, Joan Marie Kraft, Lee Warner, John E. Anderson, and Denise J. Jamieson. Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop K-34, Atlanta, GA, USA


Background:
Little is known about the extent to which young women receive integrated contraceptive (counseling or prescription for birth control, pregnancy testing, or abortion) and STD/HIV (counseling, testing, or treatment) services in the United States.

Objective:
To identify contraceptive and STD/HIV services among 15-24 year-old women, the extent to which they receive both and where they access services, by age.

Method:
Weighted data from 1,328 unmarried, sexually active 15-24 year-old women from the 2002 National Survey of Family Growth were used to estimate prevalence of service receipt in the preceding year.

Result:
Overall, 82% (95% CI: 79-84%) of 15-24 year-old women reported receipt of contraceptive or STD/HIV services in the previous year (median: 4 types of services, range 0-11). Young women are more likely to receive contraceptive (79%) than STD/HIV (42%) services. Only 39% receive both types of services; with 15-22 year-olds receiving both types (41%) more often than 23-24 year-olds (32%; p=0.03). Of the 38% of young women receiving services suggestive of unprotected intercourse (pregnancy testing, abortion or emergency contraception prescription), 38% did not receive STD/HIV counseling, testing or treatment. Young women access most services at doctors' offices (51%) or community (20%) or family planning clinics (16%). Compared to 18-24 year-olds, 15-17 year-olds access services more often at community (29% vs. 19%; p=0.03) and Title X clinics (35% vs. 21%, p=0.02) and less often at doctors' offices (48% vs. 62%, p=0.02).

Conclusion:
Many sexually active 15-24 year old women receive contraceptive or STD/HIV services, but few receive both. Findings suggest that providers at doctors' offices and community/family planning clinics miss opportunities to provide integrated services.

Implications:
Interventions to change clinic policies, increase provider cross-training, and prime patients to discuss reproductive and sexual health with providers may help further integrate contraceptive and STD/HIV services for young women.