Original article
Disparities in Sexually Transmitted Infection/HIV Testing, Contraception, and Emergency Contraception Care Among Adolescent Sexual Minority Women Who Are Racial/Ethnic Minorities

https://doi.org/10.1016/j.jadohealth.2022.08.030Get rights and content

Abstract

Purpose

Sexual minority women and racial/ethnic minority women in the United States are at increased risk for sexually transmitted infections (STIs) and unintended pregnancy. Yet, we know little about STI/HIV testing and contraceptive care among women who have sex with women only and women who have sex with both women and men, and who are racial/ethnic minorities. This study examined receipt of STI/HIV testing and contraceptive care among sexually active adolescent women by sex of sexual contact(s) and race/ethnicity.

Methods

Our sample included 2,149 sexually active adolescent women from the National Survey of Family Growth (2011–2019). We examined receipt of sexual and reproductive health (SRH) services by sex of sexual contact(s) and race/ethnicity: STI and HIV testing, contraceptive counseling, contraceptive method, emergency contraception (EC) counseling, and EC method.

Results

Service receipt was low for all adolescent women, with disparities by sex of sexual contact(s) and by race/ethnicity. Women who have sex with women only had the lowest rates across all services; women who have sex with both women and men had higher rates of STI and HIV testing and EC counseling than women who have sex with men only. Non-Hispanic Black women had higher rates of STI and HIV testing than non-Hispanic White peers, and non-Hispanic Black and Hispanic women had lower rates of contraception method receipt than their non-Hispanic White peers. Racial/ethnic disparities persisted when results were stratified by sex of sexual contact(s).

Discussion

There is an unmet need for improved SRH service delivery for all adolescent women and for services that are not biased by sex of sexual contact(s) and race/ethnicity.

Section snippets

Study procedures

We analyzed 8 years of data (2011–2019) from the NSFG, a cross-sectional nationally representative survey. The probability sampling model for the NSFG oversampled Black, Hispanic, and adolescent participants. Data were collected via household interviews. The majority of data were collected via interview, using computer-assisted personal interviewing (CAPI); sensitive questions were collected via self-report, using audio computer-assisted self-interviews (ACASI). Detailed information about

Results

Less than half of respondents reported receipt of each SRH service in the last year (Table 1): 35.6% had STI testing, 18.4% had HIV testing, 28.4% received contraception counseling, 49.1% received a contraception method, 5.3% received EC counseling, and 4.8% received EC. The majority of respondents self-identified as non-Hispanic White (54.8%), 18.5% identified as non-Hispanic Black, 22.0% as Hispanic, and 4.8% as Other. In total, 75.6% of respondents were classified as WSMO, 19.8% as WSWM, and

Discussion

This study examined disparities in SRH service receipt by sex of sexual contact(s) and race/ethnicity among sexually active adolescent women aged 15–19 in the United States between 2011 and 2019. We identified low rates of SRH service receipt across all sexually active adolescent women, with disparities in STI and HIV testing and contraception care by sex of sexual contact(s) and race/ethnicity. By examining WSWO and WSWM separately, we were able to identify key differences in SRH care receipt:

Acknowledgments

This work was supported by the National Institute of Child Health and Human Development [T32HD052459], who had no involvement in the design, analysis or interpretation of data, nor in the writing of the report nor decision to submit for publication. This work was presented as an abstract and poster symposium at the Society for Adolescent Health and Medicine Annual Meeting (2021).

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    • Conflicts of interest: The authors have no conflicts of interest to disclose.

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