Paper
Saturday, July 24, 2004
PID and Abuse Among Minority Adolescents With STD
Jane Dimmitt Champion, PhD, FNP, CS1, J. M. Piper, MD2, R. N. Shain, PhD2, J. Korte, PhD3, A. Holden, MA3, and S. Perdue, DrPh4. (1) Department of Family Nursing Care, The Univ of Texas Health Science Center at San Antonio, San Antonio, TX, USA, (2) Department of Obstetrics and Gynecology, The Univ of Texas Health Science Center at San Antonio, San Antonio, TX, USA, (3) Department of Obstetrics and Gynecology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA, (4) Department of Microbiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| Learning Objective #1: Describe the health-seeking behaviors contributing to PID among minority adolescent women with STD |
| Learning Objective #2: Describe the relationship of sexual or physical abuse and PID among minority adolescents with STD |
Background: Adolescent women with a history of physical or sexual abuse report higher sexual risk behavior and STD rates than non-abused. Psychological effects of abuse include depression, decreased self-efficacy and somatization that can prevent women from making behavioral changes to prevent recurrence of abuse or transmission of disease. This study examined the relationship of sexual or physical abuse, genitourinary symptomatology and risk for pelvic inflammatory disease (PID) among minority adolescent women with current STD. Methods: Mexican and African-American adolescent women (<19 years) (n=373) with STD in a control-randomized trial for prevention of STD re-infection, underwent questioning regarding sexual or physical abuse, current genitourinary symptomatology, health seeking and sexual risk behaviors to determine the effect of sexual and physical abuse on reported symptomatology and PID risk. Results: Comparisons indicated abused adolescents had earlier coitus (13.71 vs. 14.74 years, p<.001), more partners per year of sexual activity (2.61 vs. 1.25, p=.002) and higher risk relationships (concurrent partners (30% vs. 14%, p<.001, partners who were having sex with others 55% vs, 37%, p<.001). More abused had STD history (33% vs. 19%, p<.03) and PID (p<.005) than nonabused. They also reported greater genitourinary symptomatology including vaginal discharge (p<.01), abdominal pain (p<.001), dysuria (p=.05) and dyspareunia (p<.001). On physical examination, abused were noted by clinicians to have more abnormal exams. They waited longer to seek health care for genitourinary symptoms (2.48 vs. 1.71 days, p=.02) and reported multiple barriers to health care (>2 barriers 57% vs. 40%, p<.001), including money, no health insurance, symptoms go away and feeling ashamed. Results indicated the odds of re-infection were twice as high for abused versus non-abused adolescents. Conclusions: Abused adolescent’s reports of relatively higher sexual risk behaviors, genitourinary symptomatology, clinical examination and previous STD and PID history place them at high risk for PID, chronic pain and infertility.
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Sigma Theta Tau International
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