Sexual Risk Behaviors and Sexually Transmitted Disease Testing Among California Adolescents: Results from the 2005 California Health Interview Survey

Background:
Annual chlamydia screening of sexually active adolescent females is recommended, yet low screening rates persist. Population-based, state-level data are needed to understand adolescent STD testing patterns and inform efforts to improve screening.

Objective:
1) Determine rates and correlates of STD testing among California teens, using population-based survey data
2) Examine the representativeness of the data source.

Method:
We analyzed 2005 random-digit-dial California Health Interview Survey (CHIS) data from 43,020 households. One adult in each household was selected for interview; adolescents (ages 12 to 17 years) were eligible for participation if they resided with an interviewed parent or guardian. Adolescents were interviewed only with parental permission. We examined response rates and compared characteristics of parents of eligible responders versus non-responders.
The final analysis included interviewed adolescents who were at least 14 years old and reported previous-year sexual intercourse. We used chi-square tests to examine associations between risk factors and STD testing.

Result:
4,029 adolescents (48.5% of eligible adolescent-containing households) completed interviews. Parents of interviewed adolescents were more likely to be white (42.8% versus 33.5%, p < 0.0001) and college-educated (26.7% versus 23.8%, p = 0.03) than parents of non-responders.
The final analysis included 483 adolescents (12%) who reported previous-year sexual intercourse (229 females and 254 males). Overall, 41.5% (standard error (SE) 5.0) of females and 16.7% (SE 3.1) of males reported STD testing in the previous year. Respondents who were under age 15 at first intercourse, reported two or more previous-year partners, did not use a condom at last intercourse, or used emergency contraception in the previous year reported higher rates of testing.

Conclusion:
While California adolescents who engage in higher-risk behavior report higher rates of STD testing, caution should be exercised in interpreting adolescent data from surveys that target adults.

Implications:
Continued efforts are needed to improve collection of representative adolescent data in population-based surveys.